{"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":[1003378845],"tin":{"type":"npi","value":"1003378845"}}]},{"provider_group_id":3,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1003575085],"tin":{"type":"npi","value":"1003575085"}}]},{"provider_group_id":4,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1003861725],"tin":{"type":"npi","value":"1003861725"}}]},{"provider_group_id":5,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1487790259],"tin":{"type":"npi","value":"1487790259"}}]},{"provider_group_id":6,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1003042672],"tin":{"type":"npi","value":"1003042672"}}]},{"provider_group_id":7,"network_name":["Healthfirst Qualified Health Plan"],"provider_groups":[{"npi":[1184935264],"tin":{"type":"npi","value":"1184935264"}}]}],"in_network":[{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","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":"G0206","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"15836","name":"Exc excessive skin arm","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); arm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"40800","name":"Drainage of mouth lesion","description":"Drainage of abscess, cyst, hematoma, vestibule of mouth; simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45331","name":"Sigmoidoscopy and biopsy","description":"Sigmoidoscopy, flexible; with biopsy, single or multiple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"0074A","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78006","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28344","name":"Repair extra toe(s)","description":"Reconstruction, toe(s); polydactyly","date_of_service":"2026-05-10","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":"84165","name":"Protein e-phoresis serum","description":"Protein; electrophoretic fractionation and quantitation, serum","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1650","name":"Ho abduction hip adjustable","description":"Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":"94060","name":"Evaluation of wheezing","description":"Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"J1980","name":"Hyoscyamine sulfate inj","description":"Injection, hyoscyamine sulfate, up to 0.25 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6532","name":"Compress stking bk40-50 surg","description":"Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21725","name":"Revision of neck muscle","description":"Division of sternocleidomastoid for torticollis, open operation; with cast application","date_of_service":"2026-05-10","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":"27266","name":"Treat hip dislocation","description":"Closed treatment of post hip arthroplasty dislocation; requiring regional or general anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":490.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76981","name":"Use parenchyma","description":"Ultrasound, elastography; parenchyma (eg, organ)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0236","name":"Pump for water circulating p","description":"Pump for water circulating pad","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15832","name":"Exc excessive skin thigh","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); thigh","date_of_service":"2026-05-10","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":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"33730","name":"Repair heart-vein defect(s)","description":"Complete repair of anomalous pulmonary venous return (supracardiac, intracardiac, or infracardiac types)","date_of_service":"2026-05-10","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":"Q0484","name":"Monitor elec or comb vad rep","description":"Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75962","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1558.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0880","name":"Trac stand free stand extrem","description":"Traction stand, free standing, extremity traction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":829.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78262","name":"Gastroesophageal reflux std","description":"Gastroesophageal reflux study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"V2307","name":"Lens sphcy trifocal 4.25-7/.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-10","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":"77331","name":"Special radiation dosimetry","description":"Special dosimetry (eg, tld, microdosimetry) (specify), only when prescribed by the treating physician","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1380.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93985","name":"Dup-scan hemo compl bi std","description":"Duplex scan of arterial inflow and venous outflow for preoperative vessel assessment prior to creation of hemodialysis access; complete bilateral study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26550","name":"Pollicization digit","description":"Pollicization of a digit","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1386.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0291","name":"Hosp bed fx ht w/o rail w/o","description":"Hospital bed, fixed height, without side rails, without mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"69715","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0460","name":"Tlso 2 shl symphys-stern cst","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the s","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78258","name":"Esophageal motility","description":"Esophageal motility","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83919","name":"Organic acids qual each","description":"Organic acids; qualitative, each specimen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"45100","name":"Biopsy of rectum","description":"Biopsy of anorectal wall, anal approach (eg, congenital megacolon)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67220","name":"Treatment of choroid lesion","description":"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photocoagulation (eg, laser), 1 or more sessions","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1002.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","date_of_service":"2026-05-10","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":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-10","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":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77789","name":"Apply surf ldr radionuclide","description":"Surface application of low dose rate radionuclide source","date_of_service":"2026-05-10","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":"J7517","name":"Mycophenolate mofetil oral","description":"Mycophenolate mofetil, oral, 250 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"93012","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"51772","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":345.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"60270","name":"Removal of thyroid","description":"Thyroidectomy, including substernal thyroid; sternal split or transthoracic approach","date_of_service":"2026-05-10","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":"31528","name":"Laryngoscopy and dilation","description":"Laryngoscopy direct, with or without tracheoscopy; with dilation, initial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","date_of_service":"2026-05-10","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":"94370","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":337.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1763.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KN"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":607.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01932","name":"Anes th ivnt rad ntrthrc/jug","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); intrathoracic or jugular","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93616","name":"Esophageal recording w/pacg","description":"Esophageal recording of atrial electrogram with or without ventricular electrogram(s); with pacing","date_of_service":"2026-05-10","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":"83150","name":"Assay of homovanillic acid","description":"Homovanillic acid (hva)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP11","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"75885","name":"Vein x-ray liver w/hemodynam","description":"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00840","name":"Anes iper px lower abd nos","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; not otherwise specified","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","date_of_service":"2026-05-10","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":"86696","name":"Herpes simplex type 2 test","description":"Antibody; herpes simplex, type 2","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"90901","name":"Biofeedback train any meth","description":"Biofeedback training by any modality","date_of_service":"2026-05-10","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":"78660","name":"Nuclear exam of tear flow","description":"Radiopharmaceutical dacryocystography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6232","name":"Hydrogel dsg>16<=48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size greater than 16 sq. in., but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-10","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":"75896","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1298","name":"Wheelchair spec seat depth/w","description":"Special wheelchair seat depth and/or width, by construction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28450","name":"Tx tarsal b1 fx w/o mnpj ea","description":"Treatment of tarsal bone fracture (except talus and calcaneus); without manipulation, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75722","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":717.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","date_of_service":"2026-05-10","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":"52275","name":"Cystoscopy & revise urethra","description":"Cystourethroscopy, with internal urethrotomy; male","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78075","name":"Adrenal cortex & medulla img","description":"Adrenal imaging, cortex and/or medulla","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","date_of_service":"2026-05-10","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":"82926","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"49002","name":"Reopening of abdomen","description":"Reopening of recent laparotomy","date_of_service":"2026-05-10","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":"01202","name":"Anes arthroscopic px hip jt","description":"Anesthesia for arthroscopic procedures of hip joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"83088","name":"Assay of histamine","description":"Histamine","date_of_service":"2026-05-10","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":"54390","name":"Repair penis and bladder","description":"Plastic operation on penis for epispadias distal to external sphincter; with exstrophy of bladder","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36262","name":"Removal of infusion pump","description":"Removal of implanted intra-arterial infusion pump","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"J7191","name":"Factor viii (porcine)","description":"Factor viii (antihemophilic factor (porcine)), per i.u.","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94729","name":"Diffusing capacity","description":"Diffusing capacity (eg, carbon monoxide, membrane) (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"75831","name":"Vein x-ray kidney","description":"Venography, renal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0500","name":"Ippb all types","description":"Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-10","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":"67311","name":"Revise eye muscle","description":"Strabismus surgery, recession or resection procedure; 1 horizontal muscle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"G0103","name":"Psa screening","description":"Prostate cancer screening; prostate specific antigen test (psa)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77600","name":"Hyperthermia ext gen supfc","description":"Hyperthermia, externally generated; superficial (ie, heating to a depth of 4 cm or less)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64561","name":"Implant neuroelectrodes","description":"Percutaneous implantation of neurostimulator electrode array; sacral nerve (transforaminal placement) including image guidance, if performed","date_of_service":"2026-05-10","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":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36010","name":"Place catheter in vein","description":"Introduction of catheter, superior or inferior vena cava","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"89135","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1836","name":"Ko rigid w/o joints pre ots","description":"Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27324","name":"Biopsy thigh soft tissues","description":"Biopsy, soft tissue of thigh or knee area; deep (subfascial or intramuscular)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"0466T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-10","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":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6543","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51880","name":"Repair of bladder opening","description":"Closure of cystostomy (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["QB","RR","QF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63042","name":"Laminotomy single lumbar","description":"Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated intervertebral disc, reexploration, single interspace; lumbar","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1520.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":641.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"52277","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with resection of external sphincter (sphincterotomy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52441","name":"Cysto insj trnsprstc 1 implt","description":"Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; single implant","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"J1630","name":"Haloperidol injection","description":"Injection, haloperidol, up to 5 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"42804","name":"Biopsy of upper nose/throat","description":"Biopsy; nasopharynx, visible lesion, simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19300","name":"Mastectomy for gynecomastia","description":"Mastectomy for gynecomastia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8613","name":"Ossicular implant","description":"Ossicula implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"46706","name":"Repr of anal fistula w/glue","description":"Repair of anal fistula with fibrin glue","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L2770","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"27498","name":"Decompression of thigh/knee","description":"Decompression fasciotomy, thigh and/or knee, multiple compartments;","date_of_service":"2026-05-10","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":"78010","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":523.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65273","name":"Repair of eye wound","description":"Repair of laceration; conjunctiva, by mobilization and rearrangement, with hospitalization","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00539","name":"Anes tracheobronchial rcnstj","description":"Anesthesia for tracheobronchial reconstruction","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"84520","name":"Assay of urea nitrogen","description":"Urea nitrogen; quantitative","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78591","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"29720","name":"Repair spica body cst/jacket","description":"Repair of spica, body cast or jacket","date_of_service":"2026-05-10","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":"61558","name":"Excision of skull/sutures","description":"Extensive craniectomy for multiple cranial suture craniosynostosis (eg, cloverleaf skull); not requiring bone grafts","date_of_service":"2026-05-10","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":"00846","name":"Anes iper px rad hystrectomy","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; radical hysterectomy","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"34401","name":"Removal of vein clot","description":"Thrombectomy, direct or with catheter; vena cava, iliac vein, by abdominal incision","date_of_service":"2026-05-10","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":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2310","name":"Lens sphc trifocal 4.25-7/>6","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1103.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6940","name":"Elbow disarticulation switch","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1183.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84144","name":"Assay of progesterone","description":"Progesterone","date_of_service":"2026-05-10","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":"Q0092","name":"Set up port xray equipment","description":"Set-up portable x-ray equipment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86277","name":"Growth hormone antibody","description":"Growth hormone, human (hgh), antibody","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21080","name":"Impres&prep def obt prosth","description":"Impression and custom preparation; definitive obturator prosthesis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88349","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"64862","name":"Repair of low back nerves","description":"Suture of; lumbar plexus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1167.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83582","name":"Assay of ketogenic steroids","description":"Ketogenic steroids, fractionation","date_of_service":"2026-05-10","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":"85250","name":"Clot factor ix ptc/chrstmas","description":"Clotting; factor ix (ptc or christmas)","date_of_service":"2026-05-10","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":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77293","name":"Respirator motion mgmt simul","description":"Respiratory motion management simulation (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1172","name":"Wheelchair amputee detach ar","description":"Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"92341","name":"Fit spectacles bifocal","description":"Fitting of spectacles, except for aphakia; bifocal","date_of_service":"2026-05-10","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":"70120","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; less than 3 views per side","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86635","name":"Coccidioides antibody","description":"Antibody; coccidioides","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1099.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"0308T","name":"Insj ocular telescope prosth","description":"Insertion of ocular telescope prosthesis including removal of crystalline lens or intraocular lens prosthesis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-10","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":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":665.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L0160","name":"Cerv sr wire occ/man pre ots","description":"Cervical, semi-rigid, wire frame occipital/mandibular support, prefabricated, off-the-shelf","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"31536","name":"Laryngoscopy w/bx & op scope","description":"Laryngoscopy, direct, operative, with biopsy; with operating microscope or telescope","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"43750","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50940","name":"Release of ureter","description":"Deligation of ureter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4419","name":"Ost pch for bar w flange/flt","description":"Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78300","name":"Bone imaging limited area","description":"Bone and/or joint imaging; limited area","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"65103","name":"Remove eye/insert implant","description":"Enucleation of eye; with implant, muscles not attached to implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"88239","name":"Tissue culture tumor","description":"Tissue culture for neoplastic disorders; solid tumor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["26"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-10","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":"88235","name":"Tissue culture placenta","description":"Tissue culture for non-neoplastic disorders; amniotic fluid or chorionic villus cells","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"29435","name":"Appl patllr tdn bearing cast","description":"Application of patellar tendon bearing (ptb) cast","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"42890","name":"Limited pharyngectomy","description":"Limited pharyngectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1271.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6456","name":"Zinc paste band w >=3in<5in/yd","description":"Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35363","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; combined aortoiliofemoral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2103.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0457","name":"Chest shell","description":"Chest shell (cuirass)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21360","name":"Opn tx dprsd malar fracture","description":"Open treatment of depressed malar fracture, including zygomatic arch and malar tripod","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":592.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1220.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1235","name":"Rigid ped wc adjustable","description":"Wheelchair, pediatric size, rigid, adjustable, with seating system","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1878.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":990.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83525","name":"Assay of insulin","description":"Insulin; total","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82626","name":"Dehydroepiandrosterone","description":"Dehydroepiandrosterone (dhea)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","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":"53852","name":"Prostatic rf thermotx","description":"Transurethral destruction of prostate tissue; by radiofrequency thermotherapy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":653.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43215","name":"Esophagoscopy flex remove fb","description":"Esophagoscopy, flexible, transoral; with removal of foreign body(s)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-05-10","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":"57452","name":"Exam of cervix w/scope","description":"Colposcopy of the cervix including upper/adjacent vagina;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"33845","name":"Excision coa w/graft","description":"Excision of coarctation of aorta, with or without associated patent ductus arteriosus; with graft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1626","name":"Granisetron hcl injection","description":"Injection, granisetron hydrochloride, 100 mcg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"76512","name":"Oph us dx b-scan","description":"Ophthalmic ultrasound, diagnostic; b-scan (with or without superimposed non-quantitative a-scan)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1600","name":"Ho flex frejka w/cov pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31580","name":"Laryngoplasty laryngeal web","description":"Laryngoplasty; for laryngeal web, with indwelling keel or stent insertion","date_of_service":"2026-05-10","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":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1504.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57156","name":"Ins vag brachytx device","description":"Insertion of a vaginal radiation afterloading apparatus for clinical brachytherapy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29040","name":"Appl bdy cst sho to hip head","description":"Application of body cast, shoulder to hips; including head, minerva type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","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":"2026-05-10","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":"87077","name":"Culture aerobic identify","description":"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"J3485","name":"Zidovudine","description":"Injection, zidovudine, 10 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"93931","name":"Upper extremity study","description":"Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"35661","name":"Bpg femoral-femoral","description":"Bypass graft, with other than vein; femoral-femoral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"91020","name":"Gastric motility studies","description":"Gastric motility (manometric) studies","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38571","name":"Laparoscopy lymphadenectomy","description":"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":937.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01392","name":"Anes opn px upr tib fib&/pat","description":"Anesthesia for all open procedures on upper ends of tibia, fibula, and/or patella","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"85810","name":"Blood viscosity examination","description":"Viscosity","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76970","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45563","name":"Exploration/repair of rectum","description":"Exploration, repair, and presacral drainage for rectal injury; with colostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2213","name":"Lens sphcyl bifo 7.25-12/4.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31087","name":"Removal of frontal sinus","description":"Sinusotomy frontal; nonobliterative, with osteoplastic flap, coronal incision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69550","name":"Exc aurl glomus tum trnscanl","description":"Excision aural glomus tumor; transcanal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":840.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"45332","name":"Sigmoidoscopy w/fb removal","description":"Sigmoidoscopy, flexible; with removal of foreign body(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2510","name":"Th/wght bear quad-lat brim m","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0606","name":"Drainage board postural","description":"Postural drainage board","date_of_service":"2026-05-10","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":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73600","name":"X-ray exam of ankle","description":"Radiologic examination, ankle; 2 views","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6207","name":"Contact layer >16<= 48 sq in","description":"Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":"24360","name":"Reconstruct elbow joint","description":"Arthroplasty, elbow; with membrane (eg, fascial)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":550.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93978","name":"Vascular study","description":"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study","date_of_service":"2026-05-10","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":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"33286","name":"Rmvl subq car rhythm mntr","description":"Removal, subcutaneous cardiac rhythm monitor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"96101","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"59870","name":"Evacuate mole of uterus","description":"Uterine evacuation and curettage for hydatidiform mole","date_of_service":"2026-05-10","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":"47620","name":"Removal of gallbladder","description":"Cholecystectomy with exploration of common duct; with transduodenal sphincterotomy or sphincteroplasty, with or without cholangiography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1155.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5331","name":"Hip disart canadian sach ft","description":"Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"51525","name":"Removal of bladder lesion","description":"Cystotomy; for excision of bladder diverticulum, single or multiple (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37187","name":"Venous mech thrombectomy","description":"Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KC"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1758.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33980","name":"Remove intracorporeal device","description":"Removal of ventricular assist device, implantable intracorporeal, single ventricle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4032.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76965","name":"Echo guidance radiotherapy","description":"Ultrasonic guidance for interstitial radioelement application","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93613","name":"Intracardiac ephys 3d mapg","description":"Intracardiac electrophysiologic 3-dimensional mapping (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1910","name":"Afo sing bar clasp attach sh","description":"Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00500","name":"Anes all px on esophagus","description":"Anesthesia for all procedures on esophagus","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"J2505","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2273.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"33460","name":"Revision of tricuspid valve","description":"Valvectomy, tricuspid valve, with cardiopulmonary bypass","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"H0049","name":"Alcohol/drug screening","description":"Alcohol and/or drug screening","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-10","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":"29126","name":"Appl short arm splint dyn","description":"Application of short arm splint (forearm to hand); dynamic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"86384","name":"Nitroblue tetrazolium dye","description":"Nitroblue tetrazolium dye test (ntd)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5230","name":"Fem focal defic constant fri","description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot","date_of_service":"2026-05-10","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":"20245","name":"Bone biopsy open deep","description":"Biopsy, bone, open; deep (eg, humeral shaft, ischium, femoral shaft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95824","name":"Eeg cerebral death only","description":"Electroencephalogram (eeg); cerebral death evaluation only","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33750","name":"Shunt subclavian to pulm art","description":"Shunt; subclavian to pulmonary artery (blalock-taussig type operation)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1427.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86654","name":"Encephaltis west eqne antbdy","description":"Antibody; encephalitis, western equine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"22523","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5883.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-10","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":"49650","name":"Lap ing hernia repair init","description":"Laparoscopy, surgical; repair initial inguinal hernia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65780","name":"Ocular reconst transplant","description":"Ocular surface reconstruction; amniotic membrane transplantation, multiple layers","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":934.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":838.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","date_of_service":"2026-05-10","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":"L1833","name":"Ko adj jnt pos r sup pre ots","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"G0473","name":"Group behave couns 2-10","description":"Face-to-face behavioral counseling for obesity, group (2-10), 30 minutes","date_of_service":"2026-05-10","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":"45505","name":"Repair of rectum","description":"Proctoplasty; for prolapse of mucous membrane","date_of_service":"2026-05-10","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":"78813","name":"Pet image full body","description":"Positron emission tomography (pet) imaging; whole body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":969.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61708","name":"Revise circulation to head","description":"Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intracranial electrothrombosis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2341.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82140","name":"Assay of ammonia","description":"Ammonia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"76930","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64624","name":"Dstrj nulyt agt gnclr nrv","description":"Destruction by neurolytic agent, genicular nerve branches including imaging guidance, when performed","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"J0170","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2398.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"64772","name":"Incision of spinal nerve","description":"Transection or avulsion of other spinal nerve, extradural","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"48145","name":"Partial removal of pancreas","description":"Pancreatectomy, distal subtotal, with or without splenectomy; with pancreaticojejunostomy","date_of_service":"2026-05-10","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":"91200","name":"Liver elastography","description":"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64786","name":"Remove sciatic nerve lesion","description":"Excision of neuroma; sciatic nerve","date_of_service":"2026-05-10","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":"35511","name":"Art byp grft subclav-subclav","description":"Bypass graft, with vein; subclavian-subclavian","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"L5642","name":"Above knee leather socket","description":"Addition to lower extremity, above knee, leather socket","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"87285","name":"Treponema pallidum ag if","description":"Infectious agent antigen detection by immunofluorescent technique; treponema pallidum","date_of_service":"2026-05-10","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":"61001","name":"Remove cranial cavity fluid","description":"Subdural tap through fontanelle, or suture, infant, unilateral or bilateral; subsequent taps","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0737","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2420.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6207","name":"Contact layer >16<= 48 sq in","description":"Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"21242","name":"Reconstruction of jaw joint","description":"Arthroplasty, temporomandibular joint, with allograft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"26045","name":"Release palm contracture","description":"Fasciotomy, palmar (eg, dupuytrens contracture); open, partial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72295","name":"X-ray of lower spine disk","description":"Discography, lumbar, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"86720","name":"Leptospira antibody","description":"Antibody; leptospira","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77013","name":"Ct guide for tissue ablation","description":"Computed tomography guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43647","name":"Lap impl electrode antrum","description":"Laparoscopy, surgical; implantation or replacement of gastric neurostimulator electrodes, antrum","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6696","name":"Cus elbo skt in for con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"85810","name":"Blood viscosity examination","description":"Viscosity","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"86386","name":"Nuclear matrix protein 22","description":"Nuclear matrix protein 22 (nmp22), qualitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14300","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01742","name":"Anes opn/arthrs elbw osteot","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; osteotomy of humerus","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5063","name":"Drain ostomy pouch w/flange","description":"Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6247","name":"Hydrogel drg > 48 sq in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.78,"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":"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":"2026-05-10","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":"75966","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","date_of_service":"2026-05-10","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":"L1951","name":"Afo spiral prefab custom","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"54830","name":"Remove epididymis lesion","description":"Excision of local lesion of epididymis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25301","name":"Fusion of tendons at wrist","description":"Tenodesis at wrist; extensors of fingers","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23331","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"15829","name":"Rhytidectomy smas flap","description":"Rhytidectomy; superficial musculoaponeurotic system (smas) flap","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"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":"2026-05-10","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":"69511","name":"Extensive mastoid surgery","description":"Mastoidectomy; radical","date_of_service":"2026-05-10","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":"70370","name":"Throat x-ray & fluoroscopy","description":"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96912","name":"Photochemotherapy puva","description":"Photochemotherapy; psoralens and ultraviolet a (puva)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1178.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87197","name":"Serum bactericidal titer","description":"Serum bactericidal titer (schlichter test)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L8002","name":"Brst prsth bra & bilat form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"57265","name":"Cmbn ap colprhy w/ntrcl rpr","description":"Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed; with enterocele repair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":833.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","date_of_service":"2026-05-10","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":"36510","name":"Insertion of catheter vein","description":"Catheterization of umbilical vein for diagnosis or therapy, newborn","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"90647","name":"Hib prp-omp vacc 3 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-omp conjugate, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","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":35.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1678.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0439","name":"Stationary liquid 02","description":"Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"61140","name":"Burr hole/treph bx brain/les","description":"Burr hole(s) or trephine; with biopsy of brain or intracranial lesion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1384.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1270.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"01632","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86022","name":"Platelet antibodies","description":"Antibody identification; platelet antibodies","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1842.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6380","name":"Postop dsg cast chg wrst/elb","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow","date_of_service":"2026-05-10","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":"15730","name":"Mdfc flap w/prsrv vasc pedcl","description":"Midface flap (ie, zygomaticofacial flap) with preservation of vascular pedicle(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":937.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1757.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"83497","name":"Assay of 5-hiaa","description":"Hydroxyindolacetic acid, 5-(hiaa)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-10","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":"94680","name":"O2 uptk rst&xers dir simple","description":"Oxygen uptake, expired gas analysis; rest and exercise, direct, simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":955.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":"78466","name":"Heart infarct image","description":"Myocardial imaging, infarct avid, planar; qualitative or quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"63615","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1276.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15175","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47400","name":"Incision of liver duct","description":"Hepaticotomy or hepaticostomy with exploration, drainage, or removal of calculus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2157.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77610","name":"Hyperthermia ntrstl prb 5/<","description":"Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":512.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46744","name":"Repair of cloacal anomaly","description":"Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, sacroperineal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"52450","name":"Transurethral inc prostate","description":"Transurethral incision of prostate","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90807","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26504","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":987.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"58293","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74185","name":"Mra abd w or w/o cntrst","description":"Magnetic resonance angiography, abdomen, with or without contrast material(s)","date_of_service":"2026-05-10","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":"66740","name":"Destruction ciliary body","description":"Ciliary body destruction; cyclodialysis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"33978","name":"Remove ventricular device","description":"Removal of ventricular assist device; extracorporeal, biventricular","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1651.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"80440","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27095","name":"Injection for hip x-ray","description":"Injection procedure for hip arthrography; with anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64866","name":"Fusion of facial/other nerve","description":"Anastomosis; facial-spinal accessory","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35656","name":"Bpg femoral-popliteal","description":"Bypass graft, with other than vein; femoral-popliteal","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"99272","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95865","name":"Needle emg larynx","description":"Needle electromyography; larynx","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"68815","name":"Probe nasolacrimal duct","description":"Probing of nasolacrimal duct, with or without irrigation; with insertion of tube or stent","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88386","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-10","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":"L5722","name":"Knee-shin pneum swg frct exo","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2557.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1305.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-10","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":"25675","name":"Cltx dstl rad/uln dislc mnpj","description":"Closed treatment of distal radioulnar dislocation with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27767","name":"Cltx post ankle fx","description":"Closed treatment of posterior malleolus fracture; without manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82415","name":"Assay of chloramphenicol","description":"Chloramphenicol","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"73060","name":"X-ray exam of humerus","description":"Radiologic examination; humerus, minimum of 2 views","date_of_service":"2026-05-10","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":"82489","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1072.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":530.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"C9225","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21900.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"88366","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure","date_of_service":"2026-05-10","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":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"89225","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"54220","name":"Irrg crpra cavrnosa priapism","description":"Irrigation of corpora cavernosa for priapism","date_of_service":"2026-05-10","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":"31560","name":"Laryngoscop w/arytenoidectom","description":"Laryngoscopy, direct, operative, with arytenoidectomy;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"0503T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1377.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83632","name":"Placental lactogen","description":"Lactogen, human placental (hpl) human chorionic somatomammotropin","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15757","name":"Free skin flap microvasc","description":"Free skin flap with microvascular anastomosis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2713.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"40650","name":"Rpr lip fth vermilion only","description":"Repair lip, full thickness; vermilion only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KL"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01680","name":"Anes sho cast appl rmvl/rpr","description":"Anesthesia for shoulder cast application, removal or repair, not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1680","name":"Pelvic & hip control thigh c","description":"Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":604.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1060","name":"Wheelchair detachable arms","description":"Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1702.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":676.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42900","name":"Repair throat wound","description":"Suture pharynx for wound or injury","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":421.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"65101","name":"Removal of eye","description":"Enucleation of eye; without implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43888","name":"Gstr rstcv px opn rmvl&rplc","description":"Gastric restrictive procedure, open; removal and replacement of subcutaneous port component only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6722","name":"Hook/hand, hvy dty, vol clos","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92602","name":"Reprogram cochlear implt <7","description":"Diagnostic analysis of cochlear implant, patient younger than 7 years of age; subsequent reprogramming","date_of_service":"2026-05-10","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":"87109","name":"Mycoplasma","description":"Culture, mycoplasma, any source","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"21615","name":"Excision 1st &/cervical rib","description":"Excision first and/or cervical rib;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6250","name":"Skin seal protect moisturizr","description":"Skin sealants, protectants, moisturizers, ointments, any type, any size","date_of_service":"2026-05-10","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":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"00210","name":"Anes intracranial px nos","description":"Anesthesia for intracranial procedures; not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.12,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":428.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77781","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1143.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1137.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"24343","name":"Repr elbow lat ligmnt w/tiss","description":"Repair lateral collateral ligament, elbow, with local tissue","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85348","name":"Coagulation time otr method","description":"Coagulation time; other methods","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77615","name":"Hyperthermia ntrstl prb>5","description":"Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":857.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59841","name":"Induced abortion dilat&evac","description":"Induced abortion, by dilation and evacuation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2224.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77750","name":"Infuse radioactive materials","description":"Infusion or instillation of radioelement solution (includes 3-month follow-up care)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2050.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"77077","name":"Joint survey single view","description":"Joint survey, single view, 2 or more joints (specify)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"31375","name":"Partial removal of larynx","description":"Partial laryngectomy (hemilaryngectomy); laterovertical","date_of_service":"2026-05-10","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":"68761","name":"Close tear duct opening","description":"Closure of the lacrimal punctum; by plug, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"75662","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82104","name":"Alpha-1-antitrypsin pheno","description":"Alpha-1-antitrypsin; phenotype","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"87176","name":"Tissue homogenization cultr","description":"Homogenization, tissue, for culture","date_of_service":"2026-05-10","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":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2228.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"92325","name":"Modification of contact lens","description":"Modification of contact lens (separate procedure), with medical supervision of adaptation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82615","name":"Test for urine cystines","description":"Cystine and homocystine, urine, qualitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1327.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73100","name":"X-ray exam of wrist","description":"Radiologic examination, wrist; 2 views","date_of_service":"2026-05-10","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":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53220","name":"Treatment of urethra lesion","description":"Excision or fulguration of carcinoma of urethra","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78102","name":"Bone marrow imaging ltd","description":"Bone marrow imaging; limited area","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86816","name":"Hla typing dr/dq","description":"Hla typing; dr/dq, single antigen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"83069","name":"Hemoglobin urine","description":"Hemoglobin; urine","date_of_service":"2026-05-10","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":"97116","name":"Gait training therapy","description":"Therapeutic procedure, 1 or more areas, each 15 minutes; gait training (includes stair climbing)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82465","name":"Assay bld/serum cholesterol","description":"Cholesterol, serum or whole blood, total","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"42890","name":"Limited pharyngectomy","description":"Limited pharyngectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1107.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38220","name":"Dx bone marrow aspirations","description":"Diagnostic bone marrow; aspiration(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1164.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"78290","name":"Intestine imaging","description":"Intestine imaging (eg, ectopic gastric mucosa, meckels localization, volvulus)","date_of_service":"2026-05-10","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":"91022","name":"Duodenal motility study","description":"Duodenal motility (manometric) study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"44200","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1001.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6456","name":"Zinc paste band w >=3in<5in/yd","description":"Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39520","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83935","name":"Assay of urine osmolality","description":"Osmolality; urine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1945.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0172","name":"Cerv col sr foam 2pc pre ots","description":"Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":"35206","name":"Repair blood vessel dir uxtr","description":"Repair blood vessel, direct; upper extremity","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50394","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"K1007","name":"Bil hkaf pc s/d micro sensor","description":"Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4027","name":"Cast sup hip spica ped plstr","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), plaster","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9017","name":"Arsenic trioxide injection","description":"Injection, arsenic trioxide, 1 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4430","name":"Ost urine pch w b/bltin conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L2800","name":"Knee cap medial or lateral p","description":"Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only","date_of_service":"2026-05-10","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":"25624","name":"Cltx carpl scphd fx w/mnpj","description":"Closed treatment of carpal scaphoid (navicular) fracture; with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":809.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":758.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"A4417","name":"Ost pch w bar/bltinconv/fltr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92517","name":"Vemp test i&r cervical","description":"Vestibular evoked myogenic potential (vemp) testing, with interpretation and report; cervical (cvemp)","date_of_service":"2026-05-10","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":"49904","name":"Omental flap extra-abdom","description":"Omental flap, extra-abdominal (eg, for reconstruction of sternal and chest wall defects)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1002.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5648","name":"Above knee cushion socket","description":"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"50290","name":"Excision perinephric cyst","description":"Excision of perinephric cyst","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"L1650","name":"Ho abduction hip adjustable","description":"Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00914","name":"Anes trurl px rescj prst8","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of prostate","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0620","name":"Calcium glycer & lact/10 ml","description":"Injection, calcium glycerophosphate and calcium lactate, per 10 ml","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"95929","name":"C motor evoked lwr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); lower limbs","date_of_service":"2026-05-10","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":"23802","name":"Arthrd glenohumeral jt w/grf","description":"Arthrodesis, glenohumeral joint; with autogenous graft (includes obtaining graft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1084.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27438","name":"Revise kneecap with implant","description":"Arthroplasty, patella; with prosthesis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":990.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"86720","name":"Leptospira antibody","description":"Antibody; leptospira","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L7402","name":"Add ue prost s/d ultlite mat","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29540","name":"Strapping ankle &/foot","description":"Strapping; ankle and/or foot","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"28555","name":"Repair foot dislocation","description":"Open treatment of tarsal bone dislocation, includes internal fixation, when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61850","name":"Implant neuroelectrodes","description":"Twist drill or burr hole(s) for implantation of neurostimulator electrodes, cortical","date_of_service":"2026-05-10","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":"93702","name":"Bis xtracell fluid analysis","description":"Bioimpedance spectroscopy (bis), extracellular fluid analysis for lymphedema assessment(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15825","name":"Rhytdct nck pltysml tghtg","description":"Rhytidectomy; neck with platysmal tightening (platysmal flap, p-flap)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5617","name":"Ak/bk self-aligning unit ea","description":"Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each","date_of_service":"2026-05-10","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":"63050","name":"Cervical laminoplsty 2/> seg","description":"Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments;","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37233","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"65920","name":"Remove implant of eye","description":"Removal of implanted material, anterior segment of eye","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":756.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"67800","name":"Remove eyelid lesion","description":"Excision of chalazion; single","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2828.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":588.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":735.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"50520","name":"Close kidney-skin fistula","description":"Closure of nephrocutaneous or pyelocutaneous fistula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87252","name":"Virus inoculation tissue","description":"Virus isolation; tissue culture inoculation, observation, and presumptive identification by cytopathic effect","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L7007","name":"Adult electric hand","description":"Electric hand, switch or myoelectric controlled, adult","date_of_service":"2026-05-10","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":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"31715","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"15365","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1737.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"31579","name":"Laryngoscopy telescopic","description":"Laryngoscopy, flexible or rigid telescopic, with stroboscopy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"95908","name":"Nrv cndj tst 3-4 studies","description":"Nerve conduction studies; 3-4 studies","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"44021","name":"Decompress small bowel","description":"Enterotomy, small intestine, other than duodenum; for decompression (eg, baker tube)","date_of_service":"2026-05-10","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":"28260","name":"Release of midfoot joint","description":"Capsulotomy, midfoot; medial release only (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":571.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80154","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00916","name":"Anes trurl px rescj bleeding","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); post-transurethral resection bleeding","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":822.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5420","name":"Postop dsg & 1 cast chg ak/d","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change ak or knee disarticulation","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2210","name":"Lens sphcy bifocal 4.25-7/ov","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-10","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":"61321","name":"Crnec/crnot drg icr abs ittl","description":"Craniectomy or craniotomy, drainage of intracranial abscess; infratentorial","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84163","name":"Pappa serum","description":"Pregnancy-associated plasma protein-a (papp-a)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"57010","name":"Colpotomy drg pel abscess","description":"Colpotomy; with drainage of pelvic abscess","date_of_service":"2026-05-10","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":"77385","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0625","name":"Lo flex l1-below l5 pre ots","description":"Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78607","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"82677","name":"Assay of estriol","description":"Estriol","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1172","name":"Wheelchair amputee detach ar","description":"Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":"39531","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1161.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":904.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","date_of_service":"2026-05-10","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":"78601","name":"Brain image w/flow < 4 views","description":"Brain imaging, less than 4 static views; with vascular flow","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0117","name":"Glaucoma scrn hgh risk direc","description":"Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1012.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"75891","name":"Vein x-ray liver","description":"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","date_of_service":"2026-05-10","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":"92065","name":"Orthop traing pfrmd phys/qhp","description":"Orthoptic training; performed by a physician or other qualified health care professional","date_of_service":"2026-05-10","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":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43100","name":"Excision of esophagus lesion","description":"Excision of lesion, esophagus, with primary repair; cervical approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"88349","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KM"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":928.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62284","name":"Injection for myelogram","description":"Injection procedure for myelography and/or computed tomography, lumbar","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49429","name":"Removal of shunt","description":"Removal of peritoneal-venous shunt","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49061","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"73540","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["26"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","date_of_service":"2026-05-10","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":"86677","name":"Helicobacter pylori antibody","description":"Antibody; helicobacter pylori","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"85260","name":"Clot factor x stuart-power","description":"Clotting; factor x (stuart-prower)","date_of_service":"2026-05-10","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":"45562","name":"Exploration/repair of rectum","description":"Exploration, repair, and presacral drainage for rectal injury;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4265","name":"Paraffin","description":"Paraffin, per pound","date_of_service":"2026-05-10","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":"84066","name":"Assay prostate phosphatase","description":"Phosphatase, acid; prostatic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"82491","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5044.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":771.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38115","name":"Repair of ruptured spleen","description":"Repair of ruptured spleen (splenorrhaphy) with or without partial splenectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31766","name":"Carinal reconstruction","description":"Carinal reconstruction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2179.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3913","name":"Hfo w/o joints cf","description":"Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":661.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"99251","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"33414","name":"Repair of aortic valve","description":"Repair of left ventricular outflow tract obstruction by patch enlargement of the outflow tract","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70360","name":"X-ray exam of neck","description":"Radiologic examination; neck, soft tissue","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":649.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50360","name":"Rnl altrnsplj w/o rcp nfrct","description":"Renal allotransplantation, implantation of graft; without recipient nephrectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2262.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1820","name":"Soft interface material","description":"Replacement soft interface material, dynamic adjustable extension/flexion device","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28043","name":"Exc foot/toe tum sc < 1.5 cm","description":"Excision, tumor, soft tissue of foot or toe, subcutaneous; less than 1.5 cm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-05-10","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":"00539","name":"Anes tracheobronchial rcnstj","description":"Anesthesia for tracheobronchial reconstruction","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42226","name":"Lengthening of palate","description":"Lengthening of palate, and pharyngeal flap","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77431","name":"Radiation therapy management","description":"Radiation therapy management with complete course of therapy consisting of 1 or 2 fractions only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99300","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43621","name":"Removal of stomach","description":"Gastrectomy, total; with roux-en-y reconstruction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1902.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76095","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"J7051","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-10","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":"82145","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"31205","name":"Removal of ethmoid sinus","description":"Ethmoidectomy; extranasal, total","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0373","name":"Nonpowered pressure mattress","description":"Nonpowered advanced pressure reducing mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["26"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67312","name":"Revise two eye muscles","description":"Strabismus surgery, recession or resection procedure; 2 horizontal muscles","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"73600","name":"X-ray exam of ankle","description":"Radiologic examination, ankle; 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"84443","name":"Assay thyroid stim hormone","description":"Thyroid stimulating hormone (tsh)","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"90632","name":"Hepa vaccine adult im","description":"Hepatitis a vaccine (hepa), adult dosage, for intramuscular use","date_of_service":"2026-05-10","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":73.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24931","name":"Amputate upper arm & implant","description":"Amputation, arm through humerus; with implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"51795","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","date_of_service":"2026-05-10","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":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","date_of_service":"2026-05-10","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":"01852","name":"Anes px vn f/arm phlbrrhaphy","description":"Anesthesia for procedures on veins of forearm, wrist, and hand; phleborrhaphy","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67440","name":"Explore/drain eye socket","description":"Orbitotomy with bone flap or window, lateral approach (eg, kroenlein); with drainage","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["TC"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1374.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["KE","NU"]}],"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":"2026-05-10","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":"33814","name":"Obltrj a-pulm sep def w/byp","description":"Obliteration of aortopulmonary septal defect, with cardiopulmonary bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1897.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"00522","name":"Anes clsd ch px ndl bx pleur","description":"Anesthesia for closed chest procedures; needle biopsy of pleura","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":733.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76700","name":"Us exam abdom complete","description":"Ultrasound, abdominal, real time with image documentation; complete","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3702","name":"Eo w/o joints cf","description":"Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63278","name":"Bx/exc xdrl spine lesn scrl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, sacral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1716.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0572","name":"Aerosol compressor adjust pr","description":"Aerosol compressor, adjustable pressure, light duty for intermittent use","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"46220","name":"Excise anal ext tag/papilla","description":"Excision of single external papilla or tag, anus","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0984","name":"Add pwr tiller","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"G0462","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71048","name":"X-ray exam chest 4+ views","description":"Radiologic examination, chest; 4 or more views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00566","name":"Anes direct cabg w/o pump","description":"Anesthesia for direct coronary artery bypass grafting; without pump oxygenator","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":"92555","name":"Speech threshold audiometry","description":"Speech audiometry threshold;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82757","name":"Assay of semen fructose","description":"Fructose, semen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8642","name":"Hallux implant","description":"Hallux implant","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"67505","name":"Inject/treat eye socket","description":"Retrobulbar injection; alcohol","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"43772","name":"Lap rmvl gastr adj device","description":"Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device component only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1040.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-10","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":"59015","name":"Chorion biopsy","description":"Chorionic villus sampling, any method","date_of_service":"2026-05-10","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":"90880","name":"Hypnotherapy","description":"Hypnotherapy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86653","name":"Encephaltis st louis antbody","description":"Antibody; encephalitis, st. louis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71022","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1334.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19102","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35511","name":"Art byp grft subclav-subclav","description":"Bypass graft, with vein; subclavian-subclavian","date_of_service":"2026-05-10","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":"87188","name":"Sc std macrobroth dil meth","description":"Susceptibility studies, antimicrobial agent; macrobroth dilution method, each agent","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"84275","name":"Assay of sialic acid","description":"Sialic acid","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"87622","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49425","name":"Insert abdomen-venous drain","description":"Insertion of peritoneal-venous shunt","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75996","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"66711","name":"Ecp ciliary body destruction","description":"Ciliary body destruction; cyclophotocoagulation, endoscopic, without concomitant removal of crystalline lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"37700","name":"Ligation&div long saph vein","description":"Ligation and division of long saphenous vein at saphenofemoral junction, or distal interruptions","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"00904","name":"Anes radical perineal px","description":"Anesthesia for; radical perineal procedure","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":"87470","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"75993","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-10","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":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95900","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"B9006","name":"Parenteral infus pump statio","description":"Parenteral nutrition infusion pump, stationary","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1513.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","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":"90812","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87003","name":"Small animal inoculation","description":"Animal inoculation, small animal, with observation and dissection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-10","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":"00566","name":"Anes direct cabg w/o pump","description":"Anesthesia for direct coronary artery bypass grafting; without pump oxygenator","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"96450","name":"Chemotherapy into cns","description":"Chemotherapy administration, into cns (eg, intrathecal), requiring and including spinal puncture","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0635","name":"Lso sagit rigid panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pr","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57511","name":"Cryocautery of cervix","description":"Cautery of cervix; cryocautery, initial or repeat","date_of_service":"2026-05-10","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":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"84597","name":"Assay of vitamin k","description":"Vitamin k","date_of_service":"2026-05-10","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":"76856","name":"Us exam pelvic complete","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"00212","name":"Anes icr px subdural taps","description":"Anesthesia for intracranial procedures; subdural taps","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50783","name":"Reimplant ureter in bladder","description":"Ureteroneocystostomy; with extensive ureteral tailoring","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1351.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"00846","name":"Anes iper px rad hystrectomy","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; radical hysterectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19305","name":"Mast radical","description":"Mastectomy, radical, including pectoral muscles, axillary lymph nodes","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":761.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53405","name":"Revise urethra stage 2","description":"Urethroplasty; second stage (formation of urethra), including urinary diversion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":706.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0071A","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7506","name":"Hmes/trachvalve adhesivedisk","description":"Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"A5056","name":"1 pc ost pouch w filter","description":"Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58520","name":"Repair of ruptured uterus","description":"Hysterorrhaphy, repair of ruptured uterus (nonobstetrical)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3105.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":974.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"92136","name":"Ophthalmic biometry","description":"Ophthalmic biometry by partial coherence interferometry with intraocular lens power calculation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54450","name":"Preputial stretching","description":"Foreskin manipulation including lysis of preputial adhesions and stretching","date_of_service":"2026-05-10","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":"75671","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"78206","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7507","name":"Integrated filter & holder","description":"Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"49083","name":"Abd paracentesis w/imaging","description":"Abdominal paracentesis (diagnostic or therapeutic); with imaging guidance","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"71030","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"92230","name":"Fluorescein angioscopy i&r","description":"Fluorescein angioscopy with interpretation and report","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72020","name":"X-ray exam of spine 1 view","description":"Radiologic examination, spine, single view, specify level","date_of_service":"2026-05-10","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":"27745","name":"Reinforce tibia","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate, tibia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":910.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1253.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":"86331","name":"Immunodiffusion ouchterlony","description":"Immunodiffusion; gel diffusion, qualitative (ouchterlony), each antigen or antibody","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":467.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51565","name":"Revise bladder & ureter(s)","description":"Cystectomy, partial, with reimplantation of ureter(s) into bladder (ureteroneocystostomy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1409.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0180","name":"Agalsidase beta injection","description":"Injection, agalsidase beta, 1 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1245","name":"Dipyridamole injection","description":"Injection, dipyridamole, per 10 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92071","name":"Contact lens fitting for tx","description":"Fitting of contact lens for treatment of ocular surface disease","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"45307","name":"Proctosigmoidoscopy fb","description":"Proctosigmoidoscopy, rigid; with removal of foreign body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2175","name":"Meperidine hydrochl /100 mg","description":"Injection, meperidine hydrochloride, per 100 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25545","name":"Optx ulnar shft fx int fixj","description":"Open treatment of ulnar shaft fracture, includes internal fixation, when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":825.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1532.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72069","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"78607","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78140","name":"Red cell sequestration","description":"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":"35601","name":"Bpg com crtd-ipsi int crtd","description":"Bypass graft, with other than vein; common carotid-ipsilateral internal carotid","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"00770","name":"Anes px maj abd blood vessel","description":"Anesthesia for all procedures on major abdominal blood vessels","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"51102","name":"Drain bl w/cath insertion","description":"Aspiration of bladder; with insertion of suprapubic catheter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"82205","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"72190","name":"X-ray exam of pelvis","description":"Radiologic examination, pelvis; complete, minimum of 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64786","name":"Remove sciatic nerve lesion","description":"Excision of neuroma; sciatic nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1263.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-05-10","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":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"83700","name":"Lipopro bld electrophoretic","description":"Lipoprotein, blood; electrophoretic separation and quantitation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77610","name":"Hyperthermia ntrstl prb 5/<","description":"Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86668","name":"Francisella tularensis","description":"Antibody; francisella tularensis","date_of_service":"2026-05-10","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":"53502","name":"Repair of urethra injury","description":"Urethrorrhaphy, suture of urethral wound or injury, female","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0343","name":"Laparotomy islet cell transp","description":"Laparotomy for islet cell transplant, includes portal vein catheterization and infusion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":680.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1008.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0670","name":"Inj mepivacaine hcl/10 ml","description":"Injection, mepivacaine hydrochloride, per 10 ml","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23921","name":"Disarticulation sho sec clsr","description":"Disarticulation of shoulder; secondary closure or scar revision","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1055.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00870","name":"Anes xtrprtl cystolithotomy","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; cystolithotomy","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0762","name":"Trans elec jt stim dev sys","description":"Transcutaneous electrical joint stimulation device system, includes all accessories","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2624","name":"Hip adj flex ext abduct cont","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45020","name":"Drainage of rectal abscess","description":"Incision and drainage of deep supralevator, pelvirectal, or retrorectal abscess","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":582.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80160","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5615","name":"Ak 4 bar link hydl swg/stanc","description":"Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33245","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1086.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97504","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5681","name":"Intl custm cong/latyp insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27840","name":"Treat ankle dislocation","description":"Closed treatment of ankle dislocation; without anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S0190","name":"Mifepristone, oral, 200 mg","description":"Mifepristone, oral, 200 mg","date_of_service":"2026-05-10","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":"93721","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21010","name":"Incision of jaw joint","description":"Arthrotomy, temporomandibular joint","date_of_service":"2026-05-10","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":"33724","name":"Repair venous anomaly","description":"Repair of isolated partial anomalous pulmonary venous return (eg, scimitar syndrome)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75980","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"56640","name":"Vlvctmy rad comp w/lymphadec","description":"Vulvectomy, radical, complete, with inguinofemoral, iliac, and pelvic lymphadenectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1587.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84430","name":"Assay of thiocyanate","description":"Thiocyanate","date_of_service":"2026-05-10","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":"28715","name":"Arthrodesis triple","description":"Arthrodesis; triple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1137.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8512","name":"Gel cap for trach voice pros","description":"Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"66700","name":"Destruction ciliary body","description":"Ciliary body destruction; diathermy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2760","name":"Extension per extension per","description":"Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5280","name":"Hemipelvect canad sing axis","description":"Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2296.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"87660","name":"Trichomonas vagin dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); trichomonas vaginalis, direct probe technique","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":789.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":776.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70552","name":"Mri brain stem w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"0031A","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78594","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"Q0479","name":"Power module combo vad, rep","description":"Power module for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1092.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"58661","name":"Laparoscopy remove adnexa","description":"Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1919.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1358.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L2060","name":"Hkafo torsion ball bearing j","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-10","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":"0478T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77620","name":"Hyperthermia gen intrcv prb","description":"Hyperthermia generated by intracavitary probe(s)","date_of_service":"2026-05-10","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":"23065","name":"Biopsy shoulder tissues","description":"Biopsy, soft tissue of shoulder area; superficial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82044","name":"Ur albumin semiquantitative","description":"Albumin; urine (eg, microalbumin), semiquantitative (eg, reagent strip assay)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"85670","name":"Thrombin time plasma","description":"Thrombin time; plasma","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0738","name":"Portable gas oxygen system","description":"Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["MS"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KF"]}],"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":"2026-05-10","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":"82787","name":"Igg 1 2 3 or 4 each","description":"Gammaglobulin (immunoglobulin); immunoglobulin subclasses (eg, igg1, 2, 3, or 4), each","date_of_service":"2026-05-10","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":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0245","name":"Tub stool or bench","description":"Tub stool or bench","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01999","name":"Unlisted anes procedure","description":"Unlisted anesthesia procedure(s)","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78315","name":"Bone imaging 3 phase","description":"Bone and/or joint imaging; 3 phase study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63744","name":"Revision of spinal shunt","description":"Replacement, irrigation or revision of lumbosubarachnoid shunt","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":695.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1848","name":"Ko dbl upright w/air pre ots","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"26030","name":"Drainage of palm bursas","description":"Drainage of palmar bursa; multiple bursa","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","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":"78195","name":"Lymph system imaging","description":"Lymphatics and lymph nodes imaging","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"45136","name":"Excise ileoanal reservior","description":"Excision of ileoanal reservoir with ileostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78601","name":"Brain image w/flow < 4 views","description":"Brain imaging, less than 4 static views; with vascular flow","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2000","name":"Gastric suction pump hme mdl","description":"Gastric suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"G0115","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-10","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":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E1171","name":"Wheelchair amputee w/o leg r","description":"Amputee wheelchair, fixed full length arms, without footrests or legrest","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1235","name":"Rigid ped wc adjustable","description":"Wheelchair, pediatric size, rigid, adjustable, with seating system","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35546","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1789.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99336","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36838","name":"Dist revas ligation hemo","description":"Distal revascularization and interval ligation (dril), upper extremity hemodialysis access (steal syndrome)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1479.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"95816","name":"Eeg awake and drowsy","description":"Electroencephalogram (eeg); including recording awake and drowsy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6638","name":"Elec lock on manual pw elbow","description":"Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82980","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38206","name":"Harvest auto stem cells","description":"Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; autologous","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1522.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"33272","name":"Rmvl of subq defibrillator","description":"Removal of subcutaneous implantable defibrillator electrode","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95833","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"29838","name":"Elbow arthroscopy/surgery","description":"Arthroscopy, elbow, surgical; debridement, extensive","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":725.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"93734","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77787","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"23334","name":"Shoulder prosthesis removal","description":"Removal of prosthesis, includes debridement and synovectomy when performed; humeral or glenoid component","date_of_service":"2026-05-10","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":"92653","name":"Aep neurodiagnostic i&r","description":"Auditory evoked potentials; neurodiagnostic, with interpretation and report","date_of_service":"2026-05-10","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":"88358","name":"Analysis tumor","description":"Morphometric analysis; tumor (eg, dna ploidy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11463","name":"Exc skn hdrdnt ing complex","description":"Excision of skin and subcutaneous tissue for hidradenitis, inguinal; with complex repair","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"39502","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1142.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6254","name":"Absorpt drg <=16 sq in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0288","name":"Recon, cta for surg plan","description":"Reconstruction, computed tomographic angiography of aorta for surgical planning for vascular surgery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0238","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78271","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20822","name":"Replantation digit complete","description":"Replantation, digit, excluding thumb (includes distal tip to sublimis tendon insertion), complete amputation","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"45150","name":"Excision of rectal stricture","description":"Division of stricture of rectum","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42106","name":"Excision lesion mouth roof","description":"Excision, lesion of palate, uvula; with simple primary closure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"83593","name":"Fractionation ketosteroids","description":"Ketosteroids, 17- (17-ks); fractionation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0373","name":"Nonpowered pressure mattress","description":"Nonpowered advanced pressure reducing mattress","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61682","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; supratentorial, complex","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5063.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31720","name":"Clearance of airways","description":"Catheter aspiration (separate procedure); nasotracheal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75801","name":"Lymph vessel x-ray arm/leg","description":"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"83788","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"30320","name":"Remove nasal foreign body","description":"Removal foreign body, intranasal; by lateral rhinotomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37181","name":"Splice spleen/kidney veins","description":"Venous anastomosis, open; splenorenal, distal (selective decompression of esophagogastric varices, any technique)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53450","name":"Revision of urethra","description":"Urethromeatoplasty, with mucosal advancement","date_of_service":"2026-05-10","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":"27334","name":"Remove knee joint lining","description":"Arthrotomy, with synovectomy, knee; anterior or posterior","date_of_service":"2026-05-10","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":"27605","name":"Incision of achilles tendon","description":"Tenotomy, percutaneous, achilles tendon (separate procedure); local anesthesia","date_of_service":"2026-05-10","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":"93603","name":"Right ventricular recording","description":"Right ventricular recording","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"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":"2026-05-10","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":"83010","name":"Assay of haptoglobin quant","description":"Haptoglobin; quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44130","name":"Bowel to bowel fusion","description":"Enteroenterostomy, anastomosis of intestine, with or without cutaneous enterostomy (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1091.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4306","name":"Drug delivery system <=50 ml","description":"Disposable drug delivery system, flow rate of less than 50 ml per hour","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77522","name":"Proton trmt simple w/comp","description":"Proton treatment delivery; simple, with compensation","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"92575","name":"Sensorineural acuity lvl tst","description":"Sensorineural acuity level test","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49200","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":"53446","name":"Remove uro sphincter","description":"Removal of inflatable urethral/bladder neck sphincter, including pump, reservoir, and cuff","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"91040","name":"Esoph balloon distension tst","description":"Esophageal balloon distension study, diagnostic, with provocation when performed","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92275","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"76819","name":"Fetal biophys profil w/o nst","description":"Fetal biophysical profile; without non-stress testing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"29898","name":"Ankle arthroscopy/surgery","description":"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, extensive","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"79403","name":"Hematopoietic nuclear tx","description":"Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous infusion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"77262","name":"Ther radiology tx plng intrm","description":"Therapeutic radiology treatment planning; intermediate","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33427","name":"Repair of mitral valve","description":"Valvuloplasty, mitral valve, with cardiopulmonary bypass; radical reconstruction, with or without ring","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68510","name":"Biopsy of tear gland","description":"Biopsy of lacrimal gland","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"94660","name":"Cpap initiation&mgmt","description":"Continuous positive airway pressure ventilation (cpap), initiation and management","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32605","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"43633","name":"Removal of stomach partial","description":"Gastrectomy, partial, distal; with roux-en-y reconstruction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1611.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1145.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"86648","name":"Diphtheria antibody","description":"Antibody; diphtheria","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4027","name":"Cast sup hip spica ped plstr","description":"Cast supplies, hip spica (one or both legs), pediatric (0-10 years), plaster","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2207","name":"Lens sphcy bifocal 4.25-7d/.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0110","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74181","name":"Mri abdomen w/o contrast","description":"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25671","name":"Perq skel fix rad/uln dislc","description":"Percutaneous skeletal fixation of distal radioulnar dislocation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"37204","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","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":"28406","name":"Prq skel fix clcnl fx w/mnpj","description":"Percutaneous skeletal fixation of calcaneal fracture, with manipulation","date_of_service":"2026-05-10","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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":682.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0941","name":"Gravity assisted traction de","description":"Gravity assisted traction device, any type","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"55860","name":"Surgical exposure prostate","description":"Exposure of prostate, any approach, for insertion of radioactive substance;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":708.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":"93014","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90656","name":"Iiv3 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","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":23.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":810.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"28113","name":"Part removal of metatarsal","description":"Ostectomy, complete excision; fifth metatarsal head","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93610","name":"Intra-atrial pacing","description":"Intra-atrial pacing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99222","name":"1st hosp ip/obs moderate 55","description":"Initial hospital inpatient or observation care, per day, for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. when using total time on the date of the encounter for code selection, 55 minutes ","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91133","name":"Electrogastrography w/test","description":"Electrogastrography, diagnostic, transcutaneous; with provocative testing","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","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":"86880","name":"Coombs test direct","description":"Antihuman globulin test (coombs test); direct, each antiserum","date_of_service":"2026-05-10","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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-10","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":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6588","name":"Shdr fair lead cable molded","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1355.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":758.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74485","name":"Dilation urtr/urt rs&i","description":"Dilation of ureter(s) or urethra, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0494","name":"Emr hd pmp elec/combo, rep","description":"Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52001","name":"Cysto w/irrg&evac mlt clots","description":"Cystourethroscopy with irrigation and evacuation of multiple obstructing clots","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90393","name":"Vaccina ig im","description":"Vaccinia immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"36834","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"76930","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80166","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69205","name":"Clear outer ear canal","description":"Removal foreign body from external auditory canal; with general anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-05-10","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":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1652","name":"Ho bi thighcuffs w sprdr bar","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2213.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78582","name":"Lung ventilat&perfus imaging","description":"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42821","name":"Remove tonsils and adenoids","description":"Tonsillectomy and adenoidectomy; age 12 or over","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72265","name":"Myelography l-s spine","description":"Myelography, lumbosacral, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93303","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; complete","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"78135","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86580","name":"Tb intradermal test","description":"Skin test; tuberculosis, intradermal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49582","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57110","name":"Vagnc compl rmvl vag wall","description":"Vaginectomy, complete removal of vaginal wall;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"0549T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","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":"62291","name":"Njx px discography crv/thrc","description":"Injection procedure for discography, each level; cervical or thoracic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":"69110","name":"Remove external ear partial","description":"Excision external ear; partial, simple repair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76856","name":"Us exam pelvic complete","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82731","name":"Assay of fetal fibronectin","description":"Fetal fibronectin, cervicovaginal secretions, semi-quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1847","name":"Ko dbl upright w/air pre cst","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"01150","name":"Anes rad px tumor of pelvis","description":"Anesthesia for radical procedures for tumor of pelvis, except hindquarter amputation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"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":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0200","name":"Heat lamp without stand","description":"Heat lamp, without stand (table model), includes bulb, or infrared element","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","date_of_service":"2026-05-10","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":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30125","name":"Removal of nose lesion","description":"Excision dermoid cyst, nose; complex, under bone or cartilage","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0625","name":"Lo flex l1-below l5 pre ots","description":"Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00580","name":"Anes heart/lung transplant","description":"Anesthesia for heart transplant or heart/lung transplant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":488.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88388","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","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":"51100","name":"Drain bladder by needle","description":"Aspiration of bladder; by needle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15834","name":"Exc excessive skin hip","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); hip","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-05-10","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":"92612","name":"Endoscopy swallow (fees) vid","description":"Flexible endoscopic evaluation of swallowing by cine or video recording;","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1805","name":"Adjust wrist ext & flex dev","description":"Dynamic adjustable wrist extension and flexion device, includes soft interface material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77470","name":"Special radiation treatment","description":"Special treatment procedure (eg, total body irradiation, hemibody radiation, per oral or endocavitary irradiation)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0198T","name":"Ocular blood flow measure","description":"Measurement of ocular blood flow by repetitive intraocular pressure sampling, with interpretation and report","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"54100","name":"Biopsy of penis","description":"Biopsy of penis; (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0501","name":"Shwr cov elec/combo vad, rep","description":"Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":856.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"57425","name":"Laparoscopy surg colpopexy","description":"Laparoscopy, surgical, colpopexy (suspension of vaginal apex)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3969","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2783","name":"Lens, >= 1.66 p/>=1.80 g","description":"Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-10","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":"76819","name":"Fetal biophys profil w/o nst","description":"Fetal biophysical profile; without non-stress testing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":518.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83775","name":"Assay malate dehydrogenase","description":"Malate dehydrogenase","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15945","name":"Exc isch pr ulc skn flp ostc","description":"Excision, ischial pressure ulcer, with skin flap closure; with ostectomy","date_of_service":"2026-05-10","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":"70260","name":"X-ray exam of skull","description":"Radiologic examination, skull; complete, minimum of 4 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-10","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":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2430","name":"Knee jnt ratchet lock ea jnt","description":"Addition to knee joint, ratchet lock for active and progressive knee extension, each joint","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"A9558","name":"Xe133 xenon 10mci","description":"Xenon xe-133 gas, diagnostic, per 10 millicuries","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0111","name":"Wet mounts/ w preparations","description":"Wet mounts, including preparations of vaginal, cervical or skin specimens","date_of_service":"2026-05-10","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":"95953","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"94200","name":"Lung function test (mbc/mvv)","description":"Maximum breathing capacity, maximal voluntary ventilation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1037","name":"Transport chair, ped size","description":"Transport chair, pediatric size","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86805","name":"Lymphocytotoxicity assay","description":"Lymphocytotoxicity assay, visual crossmatch; with titration","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"0147T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0466","name":"Tlso r fram soft ant pre cst","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled,","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"51860","name":"Repair of bladder wound","description":"Cystorrhaphy, suture of bladder wound, injury or rupture; simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24500","name":"Cltx humrl shft fx w/o mnpj","description":"Closed treatment of humeral shaft fracture; without manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73552","name":"X-ray exam of femur 2/>","description":"Radiologic examination, femur; minimum 2 views","date_of_service":"2026-05-10","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":"43456","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71021","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"78104","name":"Bone marrow imaging body","description":"Bone marrow imaging; whole body","date_of_service":"2026-05-10","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":"87254","name":"Virus inoculation shell via","description":"Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0735","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"76945","name":"Echo guide villus sampling","description":"Ultrasonic guidance for chorionic villus sampling, imaging supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"01160","name":"Anes clsd px symph pub/si jt","description":"Anesthesia for closed procedures involving symphysis pubis or sacroiliac joint","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":537.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93980","name":"Penile vascular study","description":"Duplex scan of arterial inflow and venous outflow of penile vessels; complete study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"32150","name":"Removal of lung lesion(s)","description":"Thoracotomy; with removal of intrapleural foreign body or fibrin deposit","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"28665","name":"Treat toe dislocation","description":"Closed treatment of interphalangeal joint dislocation; requiring anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88366","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49220","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1041.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"V2202","name":"Lens sphere bifocal 7.12-20.","description":"Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77076","name":"Radex osseous survey infant","description":"Radiologic examination, osseous survey, infant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63199","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"49422","name":"Remove tunneled ip cath","description":"Removal of tunneled intraperitoneal catheter","date_of_service":"2026-05-10","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":"93316","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3744.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46947","name":"Hemorrhoidopexy by stapling","description":"Hemorrhoidopexy (eg, for prolapsing internal hemorrhoids) by stapling","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"87660","name":"Trichomonas vagin dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); trichomonas vaginalis, direct probe technique","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91011","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"E0870","name":"Tract frame attach footboard","description":"Traction frame, attached to footboard, extremity traction, (e.g., bucks)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27290","name":"Amputation of leg at hip","description":"Interpelviabdominal amputation (hindquarter amputation)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"33220","name":"Repair lead pace-defib dual","description":"Repair of 2 transvenous electrodes for permanent pacemaker or implantable defibrillator","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1323.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53500","name":"Urethrlys transvag w/ scope","description":"Urethrolysis, transvaginal, secondary, open, including cystourethroscopy (eg, postsurgical obstruction, scarring)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00541","name":"Anes thrcm px 1 lung vntj","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); utilizing 1 lung ventilation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.16,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4311","name":"Catheter w/o bag 2-way latex","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83662","name":"Foam stability fetal lung","description":"Fetal lung maturity assessment; foam stability test","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10009","name":"Fna bx w/ct gdn 1st les","description":"Fine needle aspiration biopsy, including ct guidance; first lesion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58940","name":"Removal of ovary(s)","description":"Oophorectomy, partial or total, unilateral or bilateral;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5570","name":"Prep ak ischial direct form","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","date_of_service":"2026-05-10","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":"G0116","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6532","name":"Compress stking bk40-50 surg","description":"Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-10","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":"01215","name":"Anes opn revj tot hip arthrp","description":"Anesthesia for open procedures involving hip joint; revision of total hip arthroplasty","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"26262","name":"Resect distal finger tumor","description":"Radical resection of tumor, distal phalanx of finger","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"40700","name":"Repair cleft lip/nasal","description":"Plastic repair of cleft lip/nasal deformity; primary, partial or complete, unilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33690","name":"Banding pulmonary artery","description":"Banding of pulmonary artery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"39220","name":"Resect mediastinal tumor","description":"Resection of mediastinal tumor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26841","name":"Fusion of thumb","description":"Arthrodesis, carpometacarpal joint, thumb, with or without internal fixation;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":999.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37208","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"37208","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"47780","name":"Fuse bile ducts and bowel","description":"Anastomosis, roux-en-y, of extrahepatic biliary ducts and gastrointestinal tract","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1831.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q4054","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"35236","name":"Repair blvsl vn grf uxtr","description":"Repair blood vessel with vein graft; upper extremity","date_of_service":"2026-05-10","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":"21493","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"20103","name":"Expl pentrg wound extremity","description":"Exploration of penetrating wound (separate procedure); extremity","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01958","name":"Anes xtrnl cephalic version","description":"Anesthesia for external cephalic version procedure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"99420","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-05-10","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":"25230","name":"Partial removal of radius","description":"Radial styloidectomy (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"ATP02","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"49085","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":855.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0948","name":"Fracture frame attachmnts ce","description":"Fracture frame, attachments for complex cervical traction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":831.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6444","name":"Conform band n/s w>=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1948.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"56800","name":"Plastic repair introitus","description":"Plastic repair of introitus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86671","name":"Fungus nes antibody","description":"Antibody; fungus, not elsewhere specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"68110","name":"Exc les conjunctiva <1 cm","description":"Excision of lesion, conjunctiva; up to 1 cm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93042","name":"Rhythm ecg report","description":"Rhythm ecg, 1-3 leads; interpretation and report only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"48400","name":"Injection intraop add-on","description":"Injection procedure for intraoperative pancreatography (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"78003","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"45114","name":"Partial removal of rectum","description":"Proctectomy, partial, with anastomosis; abdominal and transsacral approach","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78600","name":"Brain image < 4 views","description":"Brain imaging, less than 4 static views;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":726.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":695.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"21620","name":"Ostectomy sternum partial","description":"Ostectomy of sternum, partial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"78445","name":"Vascular flow imaging","description":"Non-cardiac vascular flow imaging (ie, angiography, venography)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"78230","name":"Salivary gland imaging","description":"Salivary gland imaging;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01404","name":"Anes opn/arthrs disrtcj knee","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; disarticulation at knee","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1054.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1049.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"70486","name":"Ct maxillofacial w/o dye","description":"Computed tomography, maxillofacial area; without contrast material","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1812.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86255","name":"Fluorescent antibody screen","description":"Fluorescent noninfectious agent antibody; screen, each antibody","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":863.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"92584","name":"Electrocochleography","description":"Electrocochleography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"74480","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83861","name":"Microfluid analy tears","description":"Microfluidic analysis utilizing an integrated collection and analysis device, tear osmolarity","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"47800","name":"Reconstruction of bile ducts","description":"Reconstruction, plastic, of extrahepatic biliary ducts with end-to-end anastomosis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84703","name":"Chorionic gonadotropin assay","description":"Gonadotropin, chorionic (hcg); qualitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85240","name":"Clot factor viii ahg 1 stage","description":"Clotting; factor viii (ahg), 1-stage","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76945","name":"Echo guide villus sampling","description":"Ultrasonic guidance for chorionic villus sampling, imaging supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"85675","name":"Thrombin time titer","description":"Thrombin time; titer","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-05-10","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":"84134","name":"Assay of prealbumin","description":"Prealbumin","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0468","name":"Tlso rig fram pelvic pre cst","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal, and coronal","date_of_service":"2026-05-10","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":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"93317","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; image acquisition, interpretation and report only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45383","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"M0064","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1811","name":"Sps/pass knee device","description":"Static progressive stretch/patient actualized serial stretch knee device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2120","name":"Pulse gen sys tx endolymp fl","description":"Pulse generator system for tympanic treatment of inner ear endolymphatic fluid","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58976","name":"Transfer of embryo","description":"Gamete, zygote, or embryo intrafallopian transfer, any method","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28119","name":"Removal of heel spur","description":"Ostectomy, calcaneus; for spur, with or without plantar fascial release","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-10","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":"L0626","name":"Lo sag rig pnl stays pre cst","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5535","name":"Prep bk ptb open end socket","description":"Preparatory, below knee ptb type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92602","name":"Reprogram cochlear implt <7","description":"Diagnostic analysis of cochlear implant, patient younger than 7 years of age; subsequent reprogramming","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"G0512","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95863","name":"Needle emg 3 extremities","description":"Needle electromyography; 3 extremities with or without related paraspinal areas","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"84153","name":"Assay of psa total","description":"Prostate specific antigen (psa); total","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1831","name":"Static str toe dev ext/flex","description":"Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76380","name":"Cat scan follow-up study","description":"Computed tomography, limited or localized follow-up study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6960","name":"Shldr disartic switch contro","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31582","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2222.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J3280","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93451","name":"Right heart cath","description":"Right heart catheterization including measurement(s) of oxygen saturation and cardiac output, when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"42450","name":"Excise sublingual gland","description":"Excision of sublingual gland","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"88358","name":"Analysis tumor","description":"Morphometric analysis; tumor (eg, dna ploidy)","date_of_service":"2026-05-10","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":"93612","name":"Intraventricular pacing","description":"Intraventricular pacing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93453","name":"R&l hrt cath w/ventriclgrphy","description":"Combined right and left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed","date_of_service":"2026-05-10","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":"43324","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"28665","name":"Treat toe dislocation","description":"Closed treatment of interphalangeal joint dislocation; requiring anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","date_of_service":"2026-05-10","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":"93612","name":"Intraventricular pacing","description":"Intraventricular pacing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"73510","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5460","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee","date_of_service":"2026-05-10","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":"69714","name":"Impl oi implt skull perq esp","description":"Implantation, osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1245.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"25535","name":"Cltx ulnar shft fx w/mnpj","description":"Closed treatment of ulnar shaft fracture; with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2436.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"77084","name":"Mri bone marrow blood supply","description":"Magnetic resonance (eg, proton) imaging, bone marrow blood supply","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1644","name":"Inj heparin sodium per 1000u","description":"Injection, heparin sodium, per 1000 units","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"82261","name":"Assay of biotinidase","description":"Biotinidase, each specimen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77431","name":"Radiation therapy management","description":"Radiation therapy management with complete course of therapy consisting of 1 or 2 fractions only","date_of_service":"2026-05-10","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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2694.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":875.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61460","name":"Crnec sopl sctj 1+crnl nrv","description":"Craniectomy, suboccipital; for section of 1 or more cranial nerves","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":464.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88142","name":"Cytopath c/v thin layer","description":"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; manual screening under physician supervision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2526","name":"Th/wght bear nar m-l brim cu","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61334","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31531","name":"Laryngoscopy w/fb & op scope","description":"Laryngoscopy, direct, operative, with foreign body removal; with operating microscope or telescope","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42235","name":"Repair palate","description":"Repair of anterior palate, including vomer flap","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":933.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"70350","name":"X-ray head for orthodontia","description":"Cephalogram, orthodontic","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1139.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1227.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7194","name":"Factor ix complex","description":"Factor ix, complex, per i.u.","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77615","name":"Hyperthermia ntrstl prb>5","description":"Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15131","name":"Drm agrft t/a/l ea addl","description":"Dermal autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87150","name":"Dna/rna amplified probe","description":"Culture, typing; identification by nucleic acid (dna or rna) probe, amplified probe technique, per culture or isolate, each organism probed","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"T4539","name":"Reuse diaper/brief any size","description":"Incontinence product, diaper/brief, reusable, any size, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2820.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6244","name":"Hydrogel drg >48 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70250","name":"X-ray exam of skull","description":"Radiologic examination, skull; less than 4 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1504.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32555","name":"Aspirate pleura w/ imaging","description":"Thoracentesis, needle or catheter, aspiration of the pleural space; with imaging guidance","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"23182","name":"Prtl excision bone scapula","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), scapula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"43196","name":"Esophagoscp guide wire dilat","description":"Esophagoscopy, rigid, transoral; with insertion of guide wire followed by dilation over guide wire","date_of_service":"2026-05-10","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":"86618","name":"Lyme disease antibody","description":"Antibody; borrelia burgdorferi (lyme disease)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"78811","name":"Pet image ltd area","description":"Positron emission tomography (pet) imaging; limited area (eg, chest, head/neck)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31225","name":"Removal of upper jaw","description":"Maxillectomy; without orbital exenteration","date_of_service":"2026-05-10","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":"95929","name":"C motor evoked lwr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); lower limbs","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"44316","name":"Devise bowel pouch","description":"Continent ileostomy (kock procedure) (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1415.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93316","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; placement of transesophageal probe only","date_of_service":"2026-05-10","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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-05-10","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":"35512","name":"Art byp grft subclav-brchial","description":"Bypass graft, with vein; subclavian-brachial","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":886.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00530","name":"Anes perm transvns pm insj","description":"Anesthesia for permanent transvenous pacemaker insertion","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6449","name":"Lt compres band >=3in <5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33922","name":"Transect pulmonary artery","description":"Transection of pulmonary artery with cardiopulmonary bypass","date_of_service":"2026-05-10","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":"V2309","name":"Lens sphc trifocal 4.25-7/4.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61886","name":"Implant neurostim arrays","description":"Insertion or replacement of cranial neurostimulator pulse generator or receiver, direct or inductive coupling; with connection to 2 or more electrode arrays","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0122","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"94770","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"78586","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"66986","name":"Exchange lens prosthesis","description":"Exchange of intraocular lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":972.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":770.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-10","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":"77058","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":428.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":498.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"96151","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-10","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":"35182","name":"Rpr cgen av fistula thrx&abd","description":"Repair, congenital arteriovenous fistula; thorax and abdomen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27640","name":"Partial removal of tibia","description":"Partial excision (craterization, saucerization, or diaphysectomy), bone (eg, osteomyelitis); tibia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1075.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"87551","name":"Mycobacteria dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria species, amplified probe technique","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1411.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3929","name":"Hfo nontorsion jnts pre cst","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1301.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"82679","name":"Assay of estrone","description":"Estrone","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82180","name":"Assay of ascorbic acid","description":"Ascorbic acid (vitamin c), blood","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35518","name":"Art byp grft axillary-axilry","description":"Bypass graft, with vein; axillary-axillary","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1480.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"77321","name":"Special teletx port plan","description":"Special teletherapy port plan, particles, hemibody, total body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-10","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":"L0174","name":"Cerv sr 2pc thor ext pre ots","description":"Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"11983","name":"Remove/insert drug implant","description":"Removal with reinsertion, non-biodegradable drug delivery implant","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1510.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","date_of_service":"2026-05-10","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":"96920","name":"Excimer lsr psriasis<250sqcm","description":"Excimer laser treatment for psoriasis; total area less than 250 sq cm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8701","name":"Ewh s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand with single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-10","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":"31020","name":"Exploration maxillary sinus","description":"Sinusotomy, maxillary (antrotomy); intranasal","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6446","name":"Conform band s w>=3in <5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-10","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":"A4373","name":"Skin barrier with flange","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"21270","name":"Augmentation cheek bone","description":"Malar augmentation, prosthetic material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":806.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":682.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"58760","name":"Fimbrioplasty","description":"Fimbrioplasty","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":968.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8684","name":"Radiof trsmtr implt scrl neu","description":"Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"36145","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"21610","name":"Costotransversectomy","description":"Costotransversectomy (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75894","name":"X-rays transcath therapy","description":"Transcatheter therapy, embolization, any method, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1322.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":855.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"25394","name":"Repair carpal bone shorten","description":"Osteoplasty, carpal bone, shortening","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":663.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":806.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-10","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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87278","name":"Legion pneumophilia ag if","description":"Infectious agent antigen detection by immunofluorescent technique; legionella pneumophila","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L6696","name":"Cus elbo skt in for con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-05-10","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":"85130","name":"Chromogenic substrate assay","description":"Chromogenic substrate assay","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64726","name":"Dcmprn plantar digital nerve","description":"Decompression; plantar digital nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0291","name":"Hosp bed fx ht w/o rail w/o","description":"Hospital bed, fixed height, without side rails, without mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2204","name":"Lens sphcy bifocal 4.00d/2.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"59074","name":"Fetal fluid drainage w/us","description":"Fetal fluid drainage (eg, vesicocentesis, thoracocentesis, paracentesis), including ultrasound guidance","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24361","name":"Reconstruct elbow joint","description":"Arthroplasty, elbow; with distal humeral prosthetic replacement","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01963","name":"Anes cesarean hysterectomy","description":"Anesthesia for cesarean hysterectomy without any labor analgesia/anesthesia care","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0610","name":"Pacemaker monitr audible/vis","description":"Pacemaker monitor, self-contained, (checks battery depletion, includes audible and visible check systems)","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"48100","name":"Biopsy of pancreas open","description":"Biopsy of pancreas, open (eg, fine needle aspiration, needle core biopsy, wedge biopsy)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":537.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1830","name":"Interferon beta-1b / .25 mg","description":"Injection, interferon beta-1b, 0.25 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21387","name":"Opn tx orbit fx combined","description":"Open treatment of orbital floor blowout fracture; combined approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":890.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"33935","name":"Transplantation heart/lung","description":"Heart-lung transplant with recipient cardiectomy-pneumonectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29902","name":"Mcp joint arthroscopy surg","description":"Arthroscopy, metacarpophalangeal joint, surgical; with reduction of displaced ulnar collateral ligament (eg, stener lesion)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":658.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"67101","name":"Repair detached retina crtx","description":"Repair of retinal detachment, including drainage of subretinal fluid when performed; cryotherapy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28010","name":"Incision of toe tendon","description":"Tenotomy, percutaneous, toe; single tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1846","name":"Ko w adj flex/ext rotat mold","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L5530","name":"Prep bk ptb thermopls molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"90476","name":"Adenovirus vaccine type 4","description":"Adenovirus vaccine, type 4, live, for oral use","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"21445","name":"Optx mndblr/max alv ridge fx","description":"Open treatment of mandibular or maxillary alveolar ridge fracture (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["QB","RR","QF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77056","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"00842","name":"Anes iper px amniocentesis","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; amniocentesis","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","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":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2283.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38380","name":"Thoracic duct procedure","description":"Suture and/or ligation of thoracic duct; cervical approach","date_of_service":"2026-05-10","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":"T5999","name":"Supply, nos","description":"Supply, not otherwise specified","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87534","name":"Hiv-1 dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); hiv-1, direct probe technique","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"87273","name":"Herpes simplex 2 ag if","description":"Infectious agent antigen detection by immunofluorescent technique; herpes simplex virus type 2","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":672.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59515","name":"Cesarean delivery","description":"Cesarean delivery only; including postpartum care","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"88106","name":"Cytopath fl nongyn filter","description":"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95060","name":"Oph mucous membrane tests","description":"Ophthalmic mucous membrane tests","date_of_service":"2026-05-10","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":"53275","name":"Repair of urethra defect","description":"Excision or fulguration; urethral prolapse","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78195","name":"Lymph system imaging","description":"Lymphatics and lymph nodes imaging","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78220","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27393","name":"Lengthening of thigh tendon","description":"Lengthening of hamstring tendon; single tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":428.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20955","name":"Fibula bone graft microvasc","description":"Bone graft with microvascular anastomosis; fibula","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2795","name":"Ropivacaine hcl injection","description":"Injection, ropivacaine hydrochloride, 1 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"L6384","name":"Postop dsg cast chg shlder/t","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"87562","name":"M.avium-intra dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria avium-intracellulare, quantification","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20615","name":"Treatment of bone cyst","description":"Aspiration and injection for treatment of bone cyst","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35508","name":"Art byp grft carotid-vertbrl","description":"Bypass graft, with vein; carotid-vertebral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6447","name":"Conform band s w >=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28118","name":"Removal of heel bone","description":"Ostectomy, calcaneus;","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":657.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25251","name":"Removal of wrist prosthesis","description":"Removal of wrist prosthesis; complicated, including total wrist","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":607.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68320","name":"Revise/graft eyelid lining","description":"Conjunctivoplasty; with conjunctival graft or extensive rearrangement","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"88380","name":"Microdissection laser","description":"Microdissection (ie, sample preparation of microscopically identified target); laser capture","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85008","name":"Bl smear w/o diff wbc count","description":"Blood count; blood smear, microscopic examination without manual differential wbc count","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"35721","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"29868","name":"Meniscal trnspl knee w/scpe","description":"Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for meniscal insertion), medial or lateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42160","name":"Treatment mouth roof lesion","description":"Destruction of lesion, palate or uvula (thermal, cryo or chemical)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00216","name":"Anes icr px vascular px","description":"Anesthesia for intracranial procedures; vascular procedures","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"49428","name":"Ligation of shunt","description":"Ligation of peritoneal-venous shunt","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65110","name":"Removal of eye","description":"Exenteration of orbit (does not include skin graft), removal of orbital contents; only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":766.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4611","name":"Heavy duty battery","description":"Battery, heavy duty; replacement for patient owned ventilator","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36440","name":"Bld push tfuj 2 yr/<","description":"Push transfusion, blood, 2 years or younger","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","date_of_service":"2026-05-10","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":"L0450","name":"Tlso flex trunk/thor pre ots","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":"90857","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83873","name":"Assay of csf protein","description":"Myelin basic protein, cerebrospinal fluid","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"83866","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93926","name":"Lower extremity study","description":"Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"27246","name":"Treat thigh fracture","description":"Closed treatment of greater trochanteric fracture, without manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35538","name":"Art byp grft aortobi-iliac","description":"Bypass graft, with vein; aortobi-iliac","date_of_service":"2026-05-10","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":"73090","name":"X-ray exam of forearm","description":"Radiologic examination; forearm, 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","date_of_service":"2026-05-10","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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1563.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29876","name":"Arthrs knee surg synvct maj","description":"Arthroscopy, knee, surgical; synovectomy, major, 2 or more compartments (eg, medial or lateral)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47740","name":"Fuse gallbladder & bowel","description":"Cholecystoenterostomy; roux-en-y","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1301.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2211.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52330","name":"Cystoscopy and treatment","description":"Cystourethroscopy (including ureteral catheterization); with manipulation, without removal of ureteral calculus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93303","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; complete","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2036.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"75662","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"21338","name":"Open nasoethmoid fx w/o fixj","description":"Open treatment of nasoethmoid fracture; without external fixation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":985.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2120","name":"Pulse gen sys tx endolymp fl","description":"Pulse generator system for tympanic treatment of inner ear endolymphatic fluid","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3912","name":"Hfo flexion glove pre ots","description":"Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-05-10","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":"60210","name":"Partial thyroid excision","description":"Partial thyroid lobectomy, unilateral; with or without isthmusectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":597.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61698","name":"Brain aneurysm repr complx","description":"Surgery of complex intracranial aneurysm, intracranial approach; vertebrobasilar circulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4505.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86701","name":"Hiv-1antibody","description":"Antibody; hiv-1","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"35184","name":"Rpr cgen av fistula xtr","description":"Repair, congenital arteriovenous fistula; extremities","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1288.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"30435","name":"Revision of nose","description":"Rhinoplasty, secondary; intermediate revision (bony work with osteotomies)","date_of_service":"2026-05-10","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":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"86622","name":"Brucella antibody","description":"Antibody; brucella","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61000","name":"Remove cranial cavity fluid","description":"Subdural tap through fontanelle, or suture, infant, unilateral or bilateral; initial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":992.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1369.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9225","name":"Vantas implant","description":"Histrelin implant (vantas), 50 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2524.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":809.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90653","name":"Iiv adjuvant vaccine im","description":"Influenza vaccine, inactivated (iiv), subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","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":98.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0447","name":"Port o2 cont, liq over 4 lpm","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit, prescribed amount at rest or nighttime exceeds 4 liters per minute (lpm)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"G0443","name":"Brief alcohol misuse counsel","description":"Brief face-to-face behavioral counseling for alcohol misuse, 15 minutes","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"89136","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75741","name":"Artery x-rays lung","description":"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-10","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":"82024","name":"Assay of acth","description":"Adrenocorticotropic hormone (acth)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A6253","name":"Absorpt drg > 48 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72110","name":"X-ray exam l-2 spine 4/>vws","description":"Radiologic examination, spine, lumbosacral; minimum of 4 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-10","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":"33253","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2209.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0170","name":"Commode chair electric","description":"Commode chair with integrated seat lift mechanism, electric, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28175","name":"Resect phalanx of toe tumor","description":"Radical resection of tumor; phalanx of toe","date_of_service":"2026-05-10","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":"82172","name":"Assay of apolipoprotein","description":"Apolipoprotein, each","date_of_service":"2026-05-10","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":"77778","name":"Apply interstit radiat compl","description":"Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when performed","date_of_service":"2026-05-10","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":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":"50205","name":"Renal bx surg exposure kdn","description":"Renal biopsy; by surgical exposure of kidney","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":653.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61312","name":"Crnec/crnot sttl xdrl/sdrl","description":"Craniectomy or craniotomy for evacuation of hematoma, supratentorial; extradural or subdural","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2122.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":777.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4433","name":"Urine ost pch bar w lock fln","description":"Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each","date_of_service":"2026-05-10","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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27603","name":"Drain lower leg lesion","description":"Incision and drainage, leg or ankle; deep abscess or hematoma","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67825","name":"Revise eyelashes","description":"Correction of trichiasis; epilation by other than forceps (eg, by electrosurgery, cryotherapy, laser surgery)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77414","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"1160F","name":"Rvw meds by rx/dr in rcrd","description":"Review of all medications by a prescribing practitioner or clinical pharmacist (such as, prescriptions, otcs, herbal therapies and supplements) documented in the medical record (coa)","date_of_service":"2026-05-10","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":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73530","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"38780","name":"Remove abdomen lymph nodes","description":"Retroperitoneal transabdominal lymphadenectomy, extensive, including pelvic, aortic, and renal nodes (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63706","name":"Repair of spinal herniation","description":"Repair of myelomeningocele; larger than 5 cm diameter","date_of_service":"2026-05-10","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":"L5781","name":"Lower limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A9500","name":"Tc99m sestamibi","description":"Technetium tc-99m sestamibi, diagnostic, per study dose","date_of_service":"2026-05-10","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":"35516","name":"Art byp grft subclav-axilary","description":"Bypass graft, with vein; subclavian-axillary","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1077.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9213","name":"Interferon alfa-2a inj","description":"Injection, interferon, alfa-2a, recombinant, 3 million units","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6930","name":"Below elbow switch control","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1719.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":672.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"83970","name":"Assay of parathormone","description":"Parathormone (parathyroid hormone)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3485","name":"Shoe heel pad removable for","description":"Heel, pad, removable for spur","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27334","name":"Remove knee joint lining","description":"Arthrotomy, with synovectomy, knee; anterior or posterior","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"64716","name":"Revision of cranial nerve","description":"Neuroplasty and/or transposition; cranial nerve (specify)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":426.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45330","name":"Diagnostic sigmoidoscopy","description":"Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5611","name":"Ak 4 bar link w/fric swing","description":"Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49651","name":"Lap ing hernia repair recur","description":"Laparoscopy, surgical; repair recurrent inguinal hernia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88187","name":"Flowcytometry/read 2-8","description":"Flow cytometry, interpretation; 2 to 8 markers","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-10","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":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"79005","name":"Nuclear rx oral admin","description":"Radiopharmaceutical therapy, by oral administration","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71034","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"73701","name":"Ct lower extremity w/dye","description":"Computed tomography, lower extremity; with contrast material(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"24925","name":"Amputation follow-up surgery","description":"Amputation, arm through humerus; secondary closure or scar revision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86243","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"95958","name":"Eeg monitoring/function test","description":"Wada activation test for hemispheric function, including electroencephalographic (eeg) monitoring","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73592","name":"X-ray exam of leg infant","description":"Radiologic examination; lower extremity, infant, minimum of 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63267","name":"Excise intrspinl lesion lmbr","description":"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; lumbar","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2500","name":"Thi/glut/ischia wgt bearing","description":"Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring","date_of_service":"2026-05-10","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":"28312","name":"Revision of toe","description":"Osteotomy, shortening, angular or rotational correction; other phalanges, any toe","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-05-10","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":"59072","name":"Umbilical cord occlud w/us","description":"Fetal umbilical cord occlusion, including ultrasound guidance","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":467.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49428","name":"Ligation of shunt","description":"Ligation of peritoneal-venous shunt","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":485.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00218","name":"Anes icr px in sitting pos","description":"Anesthesia for intracranial procedures; procedures in sitting position","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"84181","name":"Western blot test","description":"Protein; western blot, with interpretation and report, blood or other body fluid","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["BA","KG","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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82726","name":"Long chain fatty acids","description":"Very long chain fatty acids","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","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":"Q0496","name":"Battery elec/combo vad, rep","description":"Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01212","name":"Anes open px hip jt disrtcj","description":"Anesthesia for open procedures involving hip joint; hip disarticulation","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85004","name":"Automated diff wbc count","description":"Blood count; automated differential wbc count","date_of_service":"2026-05-10","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":"31635","name":"Bronchoscopy w/fb removal","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal of foreign body","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4417","name":"Ost pch w bar/bltinconv/fltr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"85055","name":"Reticulated platelet assay","description":"Reticulated platelet assay","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"77790","name":"Radiation handling","description":"Supervision, handling, loading of radiation source","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0418","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":481.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31367","name":"Partial removal of larynx","description":"Laryngectomy; subtotal supraglottic, without radical neck dissection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"78811","name":"Pet image ltd area","description":"Positron emission tomography (pet) imaging; limited area (eg, chest, head/neck)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1061.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1371.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58555","name":"Hysteroscopy dx sep proc","description":"Hysteroscopy, diagnostic (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":835.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86359","name":"T cells total count","description":"T cells; total count","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27886","name":"Amputation follow-up surgery","description":"Amputation, leg, through tibia and fibula; re-amputation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":779.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":"35351","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; iliac","date_of_service":"2026-05-10","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":"L7510","name":"Prosthetic device repair rep","description":"Repair of prosthetic device, repair or replace minor parts","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51820","name":"Revision of urinary tract","description":"Cystourethroplasty with unilateral or bilateral ureteroneocystostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92981","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"97762","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"59140","name":"Treat ectopic pregnancy","description":"Surgical treatment of ectopic pregnancy; cervical, with evacuation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"64719","name":"Revise ulnar nerve at wrist","description":"Neuroplasty and/or transposition; ulnar nerve at wrist","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78813","name":"Pet image full body","description":"Positron emission tomography (pet) imaging; whole body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"78465","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":695.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-05-10","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":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"83550","name":"Iron binding test","description":"Iron binding capacity","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84437","name":"Assay of neonatal thyroxine","description":"Thyroxine; requiring elution (eg, neonatal)","date_of_service":"2026-05-10","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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"64760","name":"Incision of vagus nerve","description":"Transection or avulsion of; vagus nerve (vagotomy), abdominal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1406","name":"O2/water vapor enrich w/o he","description":"Oxygen and water vapor enriching system without heated delivery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32650","name":"Thoracoscopy w/pleurodesis","description":"Thoracoscopy, surgical; with pleurodesis (eg, mechanical or chemical)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":528.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22522","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1377.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":692.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"32140","name":"Removal of lung lesion(s)","description":"Thoracotomy; with cyst(s) removal, includes pleural procedure when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1059.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1845.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"L3975","name":"Sewhfo cap design w/o jnt cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":725.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27659","name":"Repair of leg tendon each","description":"Repair, flexor tendon, leg; secondary, with or without graft, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":616.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2206","name":"Lens sphcy bifocal 4.00d/ove","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"0241U","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"57330","name":"Repair bladder-vagina lesion","description":"Closure of vesicovaginal fistula; transvesical and vaginal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2270","name":"Varus/valgus strap padded/li","description":"Addition to lower extremity, varus/valgus correction (t) strap, padded/lined or malleolus pad","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00350","name":"Anes px major vsl neck nos","description":"Anesthesia for procedures on major vessels of neck; not otherwise specified","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76040","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1138.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"51060","name":"Removal of ureter stone","description":"Transvesical ureterolithotomy","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"41821","name":"Excision of gum flap","description":"Operculectomy, excision pericoronal tissues","date_of_service":"2026-05-10","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":"82945","name":"Glucose other fluid","description":"Glucose, body fluid, other than blood","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":812.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"B4100","name":"Food thickener oral","description":"Food thickener, administered orally, per ounce","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"93025","name":"Microvolt t-wave assess","description":"Microvolt t-wave alternans for assessment of ventricular arrhythmias","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"89321","name":"Semen anal sperm detection","description":"Semen analysis; sperm presence and motility of sperm, if performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77787","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87075","name":"Cultr bacteria except blood","description":"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"70544","name":"Mr angiography head w/o dye","description":"Magnetic resonance angiography, head; without contrast material(s)","date_of_service":"2026-05-10","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":"29895","name":"Ankle arthroscopy/surgery","description":"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; synovectomy, partial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11762","name":"Reconstruction of nail bed","description":"Reconstruction of nail bed with graft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-10","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":"63650","name":"Implant neuroelectrodes","description":"Percutaneous implantation of neurostimulator electrode array, epidural","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61050","name":"Remove brain canal fluid","description":"Cisternal or lateral cervical (c1-c2) puncture; without injection (separate procedure)","date_of_service":"2026-05-10","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":"90465","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-10","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":"17340","name":"Cryotherapy for acne","description":"Cryotherapy (co2 slush, liquid n2) for acne","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1024.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2128","name":"Kafo fem fx cast molded to p","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"V2745","name":"Tint, any color/solid/grad","description":"Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"77785","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J3010","name":"Fentanyl citrate injection","description":"Injection, fentanyl citrate, 0.1 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"88245","name":"Chromosome analysis 20-25","description":"Chromosome analysis for breakage syndromes; baseline sister chromatid exchange (sce), 20-25 cells","date_of_service":"2026-05-10","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":"76514","name":"Echo exam of eye thickness","description":"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"47135","name":"Transplantation of liver","description":"Liver allotransplantation, orthotopic, partial or whole, from cadaver or living donor, any age","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5434.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":"86732","name":"Mucormycosis antibody","description":"Antibody; mucormycosis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1133.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6445","name":"Conform band s w <3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"36514","name":"Apheresis plasma","description":"Therapeutic apheresis; for plasma pheresis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86344","name":"Leukocyte phagocytosis","description":"Leukocyte phagocytosis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1882.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"83873","name":"Assay of csf protein","description":"Myelin basic protein, cerebrospinal fluid","date_of_service":"2026-05-10","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":"25652","name":"Optx ulnar styloid fracture","description":"Open treatment of ulnar styloid fracture","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","date_of_service":"2026-05-10","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":"21245","name":"Reconstruction of jaw","description":"Reconstruction of mandible or maxilla, subperiosteal implant; partial","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-10","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":"A6402","name":"Sterile gauze <= 16 sq in","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"82239","name":"Bile acids total","description":"Bile acids; total","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1665.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"85060","name":"Blood smear interpretation","description":"Blood smear, peripheral, interpretation by physician with written report","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0130","name":"Abciximab injection","description":"Injection abciximab, 10 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0749","name":"Elec osteogen stim implanted","description":"Osteogenesis stimulator, electrical, surgically implanted","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","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":"2026-05-10","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":"83805","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33545","name":"Repair of heart damage","description":"Repair of postinfarction ventricular septal defect, with or without myocardial resection","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83497","name":"Assay of 5-hiaa","description":"Hydroxyindolacetic acid, 5-(hiaa)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"92136","name":"Ophthalmic biometry","description":"Ophthalmic biometry by partial coherence interferometry with intraocular lens power calculation","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01829","name":"Anes dx arthroscopic px wrst","description":"Anesthesia for diagnostic arthroscopic procedures on the wrist","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":965.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83919","name":"Organic acids qual each","description":"Organic acids; qualitative, each specimen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"91000","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","date_of_service":"2026-05-10","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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71260","name":"Ct thorax dx c+","description":"Computed tomography, thorax, diagnostic; with contrast material(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"30020","name":"Drainage of nose lesion","description":"Drainage abscess or hematoma, nasal septum","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75964","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"84488","name":"Test feces for trypsin","description":"Trypsin; feces, qualitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42426","name":"Excise parotid gland/lesion","description":"Excision of parotid tumor or parotid gland; total, with unilateral radical neck dissection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86812","name":"Hla typing a b or c","description":"Hla typing; a, b, or c (eg, a10, b7, b27), single antigen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78000","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26261","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0105","name":"Colorectal scrn; hi risk ind","description":"Colorectal cancer screening; colonoscopy on individual at high risk","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":485.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"89130","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1452.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86708","name":"Hepatitis a antibody","description":"Hepatitis a antibody (haab)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"80440","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27450","name":"Incision of thigh","description":"Osteotomy, femur, shaft or supracondylar; with fixation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1229.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":780.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58321","name":"Artificial insemination","description":"Artificial insemination; intra-cervical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88240","name":"Cell cryopreserve/storage","description":"Cryopreservation, freezing and storage of cells, each cell line","date_of_service":"2026-05-10","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":"28173","name":"Resect metatarsal tumor","description":"Radical resection of tumor; metatarsal","date_of_service":"2026-05-10","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":"52700","name":"Drainage of prostate abscess","description":"Transurethral drainage of prostatic abscess","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1194.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93299","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78320","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q0136","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"86759","name":"Rotavirus antibody","description":"Antibody; rotavirus","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76880","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"38382","name":"Thoracic duct procedure","description":"Suture and/or ligation of thoracic duct; abdominal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":772.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77293","name":"Respirator motion mgmt simul","description":"Respiratory motion management simulation (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-05-10","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":"E1820","name":"Soft interface material","description":"Replacement soft interface material, dynamic adjustable extension/flexion device","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0970","name":"Tlso corset front","description":"Tlso, corset front","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35507","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1432.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"72080","name":"X-ray exam thoracolmb 2/> vw","description":"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views","date_of_service":"2026-05-10","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":"A6245","name":"Hydrogel drg <= 16 in w/bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-10","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":"77328","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3366.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":503.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28130","name":"Removal of ankle bone","description":"Talectomy (astragalectomy)","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"41100","name":"Biopsy of tongue","description":"Biopsy of tongue; anterior two-thirds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92275","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19000","name":"Puncture aspir cyst breast","description":"Puncture aspiration of cyst of breast;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"93529","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"20501","name":"Njx sinus tract diagnostic","description":"Injection of sinus tract; diagnostic (sinogram)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"33010","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33478","name":"Revision of heart chamber","description":"Outflow tract augmentation (gusset), with or without commissurotomy or infundibular resection","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"77022","name":"Mri gdn parnchyma tiss abltj","description":"Magnetic resonance imaging guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88267","name":"Chromosome analys placenta","description":"Chromosome analysis, amniotic fluid or chorionic villus, count 15 cells, 1 karyotype, with banding","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1742","name":"Ibutilide fumarate injection","description":"Injection, ibutilide fumarate, 1 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0974","name":"Tlso full corset","description":"Tlso, full corset","date_of_service":"2026-05-10","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":"86060","name":"Antistreptolysin o titer","description":"Antistreptolysin 0; titer","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24920","name":"Amputation of upper arm","description":"Amputation, arm through humerus; open, circular (guillotine)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76514","name":"Echo exam of eye thickness","description":"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4431","name":"Ost pch urine w barrier/tapv","description":"Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1206.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76950","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"V2108","name":"Spherocylinder 4.25d/2.12-4d","description":"Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"75992","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"54505","name":"Biopsy of testis","description":"Biopsy of testis, incisional (separate procedure)","date_of_service":"2026-05-10","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":"61690","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; dural, simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-10","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":"77075","name":"Radex osseous survey compl","description":"Radiologic examination, osseous survey; complete (axial and appendicular skeleton)","date_of_service":"2026-05-10","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":"82725","name":"Assay of blood fatty acids","description":"Fatty acids, nonesterified","date_of_service":"2026-05-10","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":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-05-10","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":"36481","name":"Insertion of catheter vein","description":"Percutaneous portal vein catheterization by any method","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00350","name":"Anes px major vsl neck nos","description":"Anesthesia for procedures on major vessels of neck; not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0454","name":"Tlso trnk sj-t9 pre cst","description":"Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefa","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00220","name":"Anes icr px csf shunting px","description":"Anesthesia for intracranial procedures; cerebrospinal fluid shunting procedures","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1059.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2457.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32666","name":"Thoracoscopy w/wedge resect","description":"Thoracoscopy, surgical; with therapeutic wedge resection (eg, mass, nodule), initial unilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4396","name":"Static or dynami afo pre cst","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93231","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15366","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E1070","name":"Wheelchair detachable foot r","description":"Fully-reclining wheelchair, detachable arms (desk or full length) swing away detachable footrest","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KF"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"87106","name":"Fungi identification yeast","description":"Culture, fungi, definitive identification, each organism; yeast","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"47620","name":"Removal of gallbladder","description":"Cholecystectomy with exploration of common duct; with transduodenal sphincterotomy or sphincteroplasty, with or without cholangiography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1155.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"47460","name":"Incise bile duct sphincter","description":"Transduodenal sphincterotomy or sphincteroplasty, with or without transduodenal extraction of calculus (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"73540","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87081","name":"Culture screen only","description":"Culture, presumptive, pathogenic organisms, screening only;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"15821","name":"Blepharp lwr eyelid fat pad","description":"Blepharoplasty, lower eyelid; with extensive herniated fat pad","date_of_service":"2026-05-10","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":"40818","name":"Excise oral mucosa for graft","description":"Excision of mucosa of vestibule of mouth as donor graft","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4433","name":"Urine ost pch bar w lock fln","description":"Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"52450","name":"Transurethral inc prostate","description":"Transurethral incision of prostate","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"L3974","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"J3240","name":"Thyrotropin injection","description":"Injection, thyrotropin alpha, 0.9 mg, provided in 1.1 mg vial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0166","name":"Extrnl counterpulse, per tx","description":"External counterpulsation, per treatment session","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69700","name":"Close mastoid fistula","description":"Closure postauricular fistula, mastoid (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49425","name":"Insert abdomen-venous drain","description":"Insertion of peritoneal-venous shunt","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":825.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"J0278","name":"Amikacin sulfate injection","description":"Injection, amikacin sulfate, 100 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2710","name":"Neostigmine methylslfte inj","description":"Injection, neostigmine methylsulfate, up to 0.5 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":987.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":878.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"64613","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82150","name":"Assay of amylase","description":"Amylase","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"59325","name":"Revision of cervix","description":"Cerclage of cervix, during pregnancy; abdominal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43450","name":"Dilate esophagus 1/mult pass","description":"Dilation of esophagus, by unguided sound or bougie, single or multiple passes","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"94370","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"41120","name":"Partial removal of tongue","description":"Glossectomy; less than one-half tongue","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1182.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":723.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"31050","name":"Exploration sphenoid sinus","description":"Sinusotomy, sphenoid, with or without biopsy;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72198","name":"Mr angio pelvis w/o & w/dye","description":"Magnetic resonance angiography, pelvis, with or without contrast material(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":683.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":875.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29505","name":"Application long leg splint","description":"Application of long leg splint (thigh to ankle or toes)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00866","name":"Anes xtrprt lw abd adrnlctmy","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; adrenalectomy","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"K0735","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-10","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":"24065","name":"Biopsy arm/elbow soft tissue","description":"Biopsy, soft tissue of upper arm or elbow area; superficial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22210","name":"Incis 1 vertebral seg cerv","description":"Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; cervical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2056.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"99201","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"33501","name":"Repair heart vessel fistula","description":"Repair of coronary arteriovenous or arteriocardiac chamber fistula; without cardiopulmonary bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1234.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1546.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"36100","name":"Establish access to artery","description":"Introduction of needle or intracatheter, carotid or vertebral artery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51820","name":"Revision of urinary tract","description":"Cystourethroplasty with unilateral or bilateral ureteroneocystostomy","date_of_service":"2026-05-10","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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"47011","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70370","name":"Throat x-ray & fluoroscopy","description":"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique","date_of_service":"2026-05-10","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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01916","name":"Anes dx arteriography/vngrph","description":"Anesthesia for diagnostic arteriography/venography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26370","name":"Repair finger/hand tendon","description":"Repair or advancement of profundus tendon, with intact superficialis tendon; primary, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1084.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33824","name":"Repair pda div 18 yrs&older","description":"Repair of patent ductus arteriosus; by division, 18 years and older","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1455.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"78201","name":"Liver imaging static only","description":"Liver imaging; static only","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":939.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-05-10","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":"63276","name":"Bx/exc xdrl spine lesn thrc","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, thoracic","date_of_service":"2026-05-10","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":"23660","name":"Optx acute shoulder dislc","description":"Open treatment of acute shoulder dislocation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0605","name":"Repl batt lithium 4.5 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":726.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"96040","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2101","name":"Bld glucose monitor w lance","description":"Blood glucose monitor with integrated lancing/blood sample","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7518","name":"Mycophenolic acid","description":"Mycophenolic acid, oral, 180 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"58805","name":"Drainage of ovarian cyst(s)","description":"Drainage of ovarian cyst(s), unilateral or bilateral (separate procedure); abdominal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60522","name":"Removal of thymus gland","description":"Thymectomy, partial or total; sternal split or transthoracic approach, with radical mediastinal dissection (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1684.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74425","name":"Urography antegrade rs&i","description":"Urography, antegrade, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.26,"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":"24340","name":"Tenodesis biceps tdn at elbw","description":"Tenodesis of biceps tendon at elbow (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":741.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27641","name":"Partial removal of fibula","description":"Partial excision (craterization, saucerization, or diaphysectomy), bone (eg, osteomyelitis); fibula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70120","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; less than 3 views per side","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"43265","name":"Ercp lithotripsy calculi","description":"Endoscopic retrograde cholangiopancreatography (ercp); with destruction of calculi, any method (eg, mechanical, electrohydraulic, lithotripsy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67141","name":"Proph rta dtchmnt crtx dthrm","description":"Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; cryotherapy, diathermy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78011","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":778.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25130","name":"Removal of wrist lesion","description":"Excision or curettage of bone cyst or benign tumor of carpal bones;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A7017","name":"Nebulizer not used w oxygen","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"15320","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"90673","name":"Riv3 vaccine no preserv im","description":"Influenza virus vaccine, trivalent (riv3), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","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":98.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1700","name":"Hydrocortisone acetate inj","description":"Injection, hydrocortisone acetate, up to 25 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","date_of_service":"2026-05-10","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":"84525","name":"Urea nitrogen semi-quant","description":"Urea nitrogen; semiquantitative (eg, reagent strip test)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"61050","name":"Remove brain canal fluid","description":"Cisternal or lateral cervical (c1-c2) puncture; without injection (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99339","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64784","name":"Remove nerve lesion","description":"Excision of neuroma; major peripheral nerve, except sciatic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3913","name":"Hfo w/o joints cf","description":"Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["LT","AS","81","80","AF","82","RT","50"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"82530","name":"Cortisol free","description":"Cortisol; free","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L2335","name":"Anterior swing band","description":"Addition to lower extremity, anterior swing band","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35475","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1362.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0650","name":"Lso sc r ant/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, inclu","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70330","name":"X-ray exam of jaw joints","description":"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP03","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"A4611","name":"Heavy duty battery","description":"Battery, heavy duty; replacement for patient owned ventilator","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00730","name":"Anes px upper pst abdl wall","description":"Anesthesia for procedures on upper posterior abdominal wall","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"63655","name":"Implant neuroelectrodes","description":"Laminectomy for implantation of neurostimulator electrodes, plate/paddle, epidural","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"77469","name":"Io radiation tx management","description":"Intraoperative radiation treatment management","date_of_service":"2026-05-10","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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-10","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":"69662","name":"Revise middle ear bone","description":"Revision of stapedectomy or stapedotomy","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"99343","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6621","name":"Flex/ext wrist w/wo friction","description":"Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21356","name":"Opn tx dprsd zygomatic arch","description":"Open treatment of depressed zygomatic arch fracture (eg, gillies approach)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99177","name":"Ocular instrumnt screen bil","description":"Instrument-based ocular screening (eg, photoscreening, automated-refraction), bilateral; with on-site analysis","date_of_service":"2026-05-10","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":"A6251","name":"Absorpt drg <=16 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33502","name":"Coronary artery correction","description":"Repair of anomalous coronary artery from pulmonary artery origin; by ligation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1386.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92250","name":"Fundus photography w/i&r","description":"Fundus photography with interpretation and report","date_of_service":"2026-05-10","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":"54050","name":"Destruction penis lesion(s)","description":"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; chemical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49400","name":"Air injection into abdomen","description":"Injection of air or contrast into peritoneal cavity (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43341","name":"Fuse esophagus & intestine","description":"Esophagojejunostomy (without total gastrectomy); thoracic approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64722","name":"Decompression unspec nerve","description":"Decompression; unspecified nerve(s) (specify)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27580","name":"Fusion of knee","description":"Arthrodesis, knee, any technique","date_of_service":"2026-05-10","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":"33979","name":"Insert intracorporeal device","description":"Insertion of ventricular assist device, implantable intracorporeal, single ventricle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86039","name":"Antinuclear antibodies (ana)","description":"Antinuclear antibodies (ana); titer","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"58540","name":"Revision of uterus","description":"Hysteroplasty, repair of uterine anomaly (strassman type)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":587.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73110","name":"X-ray exam of wrist","description":"Radiologic examination, wrist; complete, minimum of 3 views","date_of_service":"2026-05-10","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":"88233","name":"Tissue culture skin/biopsy","description":"Tissue culture for non-neoplastic disorders; skin or other solid tissue biopsy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84157","name":"Assay of protein other","description":"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4020","name":"Cast sup lng arm splnt ped f","description":"Cast supplies, long arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"74241","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99488","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59015","name":"Chorion biopsy","description":"Chorionic villus sampling, any method","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86687","name":"Htlv-i antibody","description":"Antibody; htlv-i","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27194","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":863.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01462","name":"Anes clsd px lower l/a/f","description":"Anesthesia for all closed procedures on lower leg, ankle, and foot","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40806","name":"Incision of lip fold","description":"Incision of labial frenum (frenotomy)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2308","name":"Lens sphc trifocal 4.25-7/2.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"10080","name":"I&d pilonidal cyst simple","description":"Incision and drainage of pilonidal cyst; simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54162","name":"Lysis penil circumic lesion","description":"Lysis or excision of penile post-circumcision adhesions","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["AW"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88346","name":"Imfluor 1st 1antb stain px","description":"Immunofluorescence, per specimen; initial single antibody stain procedure","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78202","name":"Liver imaging with vasc flow","description":"Liver imaging; with vascular flow","date_of_service":"2026-05-10","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":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0467","name":"Home vent multi-function","description":"Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"82016","name":"Acylcarnitines qual","description":"Acylcarnitines; qualitative, each specimen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":566.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7042","name":"5% dextrose/normal saline","description":"5% dextrose/normal saline (500 ml = 1 unit)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00840","name":"Anes iper px lower abd nos","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"00700","name":"Anes px upr ant abd wall nos","description":"Anesthesia for procedures on upper anterior abdominal wall; not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"94360","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51550","name":"Partial removal of bladder","description":"Cystectomy, partial; simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1041.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50930","name":"Closure ureter/bowel fistula","description":"Closure of ureterovisceral fistula (including visceral repair)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77605","name":"Hyperthermia ext gen deep","description":"Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65150","name":"Revise ocular implant","description":"Reinsertion of ocular implant; with or without conjunctival graft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":655.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","date_of_service":"2026-05-10","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":"41800","name":"Drainage of gum lesion","description":"Drainage of abscess, cyst, hematoma from dentoalveolar structures","date_of_service":"2026-05-10","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":"65105","name":"Remove eye/attach implant","description":"Enucleation of eye; with implant, muscles attached to implant","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1678.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"80192","name":"Assay of procainamide","description":"Procainamide; with metabolites (eg, n-acetyl procainamide)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"36592","name":"Collect blood from picc","description":"Collection of blood specimen using established central or peripheral catheter, venous, not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57545","name":"Remove cervix/repair pelvis","description":"Excision of cervical stump, abdominal approach; with pelvic floor repair","date_of_service":"2026-05-10","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":"58950","name":"Resect ovarian malignancy","description":"Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":723.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82380","name":"Assay of carotene","description":"Carotene","date_of_service":"2026-05-10","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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":345.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65930","name":"Remove blood clot from eye","description":"Removal of blood clot, anterior segment of eye","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":651.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63283","name":"Bx/exc idrl spine lesn scrl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, sacral","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27604","name":"Drain lower leg bursa","description":"Incision and drainage, leg or ankle; infected bursa","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-10","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":"26587","name":"Reconstruct extra finger","description":"Reconstruction of polydactylous digit, soft tissue and bone","date_of_service":"2026-05-10","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":"27236","name":"Treat thigh fracture","description":"Open treatment of femoral fracture, proximal end, neck, internal fixation or prosthetic replacement","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1335.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"59409","name":"Obstetrical care","description":"Vaginal delivery only (with or without episiotomy and/or forceps);","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"74475","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2005.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75962","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2337.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"31720","name":"Clearance of airways","description":"Catheter aspiration (separate procedure); nasotracheal","date_of_service":"2026-05-10","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":"73040","name":"Contrast x-ray of shoulder","description":"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"21031","name":"Remove exostosis mandible","description":"Excision of torus mandibularis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-05-10","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":"63285","name":"Bx/exc idrl imed lesn cervl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, cervical","date_of_service":"2026-05-10","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":"L5430","name":"Postop dsg ak ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, ak or knee disarticulation, each additional cast change and realignment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"41252","name":"Repair tongue laceration","description":"Repair of laceration of tongue, floor of mouth, over 2.6 cm or complex","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7017","name":"Nebulizer not used w oxygen","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":765.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"53210","name":"Removal of urethra","description":"Urethrectomy, total, including cystostomy; female","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":635.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0500","name":"Ippb all types","description":"Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":761.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96115","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L1951","name":"Afo spiral prefab custom","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2105","name":"Spherocylinder 4.00d/4.25-6d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73560","name":"X-ray exam of knee 1 or 2","description":"Radiologic examination, knee; 1 or 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-05-10","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":"91120","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":703.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"46753","name":"Reconstruction of anus","description":"Graft (thiersch operation) for rectal incontinence and/or prolapse","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"43101","name":"Excision of esophagus lesion","description":"Excision of lesion, esophagus, with primary repair; thoracic or abdominal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28111","name":"Part removal of metatarsal","description":"Ostectomy, complete excision; first metatarsal head","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"65860","name":"Severing ads ant sgm laser","description":"Severing adhesions of anterior segment, laser technique (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":690.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"85247","name":"Clot factor viii multimetric","description":"Clotting; factor viii, von willebrand factor, multimetric analysis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"73630","name":"X-ray exam of foot","description":"Radiologic examination, foot; complete, minimum of 3 views","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4352","name":"Coude tip urinary catheter","description":"Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27071","name":"Part removal hip bone deep","description":"Partial excision, wing of ilium, symphysis pubis, or greater trochanter of femur, (craterization, saucerization) (eg, osteomyelitis or bone abscess); deep (subfascial or intramuscular)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1072.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":940.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"88362","name":"Nerve teasing preparations","description":"Nerve teasing preparations","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"88104","name":"Cytopath fl nongyn smears","description":"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"Q4048","name":"Cast sup sht leg splnt ped f","description":"Cast supplies, short leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KN"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90589","name":"Chikungunya vaccine live im","description":"Chikungunya virus vaccine, live attenuated, for intramuscular use","date_of_service":"2026-05-10","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":313.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82541","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1911.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35480","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":724.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":779.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27238","name":"Treat thigh fracture","description":"Closed treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; without manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-10","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":"95863","name":"Needle emg 3 extremities","description":"Needle electromyography; 3 extremities with or without related paraspinal areas","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93303","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; complete","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72220","name":"X-ray exam sacrum tailbone","description":"Radiologic examination, sacrum and coccyx, minimum of 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61543","name":"Removal of brain tissue","description":"Craniotomy with elevation of bone flap; for partial or subtotal (functional) hemispherectomy","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27000","name":"Tenotomy adductor hip perq","description":"Tenotomy, adductor of hip, percutaneous (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26140","name":"Revise finger joint each","description":"Synovectomy, proximal interphalangeal joint, including extensor reconstruction, each interphalangeal joint","date_of_service":"2026-05-10","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":"01382","name":"Anes dx arthrs px knee jt","description":"Anesthesia for diagnostic arthroscopic procedures of knee joint","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26140","name":"Revise finger joint each","description":"Synovectomy, proximal interphalangeal joint, including extensor reconstruction, each interphalangeal joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1025.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L0460","name":"Tlso 2 shl symphys-stern cst","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the s","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3184.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1603.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"67875","name":"Closure of eyelid by suture","description":"Temporary closure of eyelids by suture (eg, frost suture)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"44346","name":"Revision of colostomy","description":"Revision of colostomy; with repair of paracolostomy hernia (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1176.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":883.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27100","name":"Transfer of abdominal muscle","description":"Transfer external oblique muscle to greater trochanter including fascial or tendon extension (graft)","date_of_service":"2026-05-10","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":"25915","name":"Amputation of forearm","description":"Krukenberg procedure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":990.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2104","name":"Spherocylindr 4.00d/2.12-4d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64577","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"62365","name":"Remove spine infusion device","description":"Removal of subcutaneous reservoir or pump, previously implanted for intrathecal or epidural infusion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8610","name":"Ocular implant","description":"Ocular implant","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":951.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37700","name":"Ligation&div long saph vein","description":"Ligation and division of long saphenous vein at saphenofemoral junction, or distal interruptions","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":869.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64553","name":"Implant neuroelectrodes","description":"Percutaneous implantation of neurostimulator electrode array; cranial nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"57170","name":"Fitting of diaphragm/cap","description":"Diaphragm or cervical cap fitting with instructions","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27060","name":"Removal of ischial bursa","description":"Excision; ischial bursa","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":480.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9481","name":"Remote e/m new pt 10mins","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: a problem focused history;  a problem focused examination; and straightforward medical decision making, furn","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86695","name":"Herpes simplex type 1 test","description":"Antibody; herpes simplex, type 1","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"J7195","name":"Factor ix recombinant nos","description":"Injection, factor ix (antihemophilic factor, recombinant) per iu, not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2245.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"69603","name":"Revj mstdc rsltg rad mstdc","description":"Revision mastoidectomy; resulting in radical mastoidectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":498.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":527.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1889.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"92625","name":"Tinnitus assessment","description":"Assessment of tinnitus (includes pitch, loudness matching, and masking)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L2010","name":"Kafo sng solid stirrup w/o j","description":"Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), without knee joint, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6441","name":"Pad band w>=3in <5in/yd","description":"Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-10","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":"28406","name":"Prq skel fix clcnl fx w/mnpj","description":"Percutaneous skeletal fixation of calcaneal fracture, with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"93304","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"87177","name":"Ova and parasites smears","description":"Ova and parasites, direct smears, concentration and identification","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L5321","name":"Ak open end sach","description":"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"97020","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4221","name":"Supp non-insulin inf cath/wk","description":"Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs  separately)","date_of_service":"2026-05-10","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":"L3913","name":"Hfo w/o joints cf","description":"Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33050","name":"Resect heart sac lesion","description":"Resection of pericardial cyst or tumor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4648","name":"Implantable tissue marker","description":"Tissue marker, implantable, any type, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"48105","name":"Resect/debride pancreas","description":"Resection or debridement of pancreas and peripancreatic tissue for acute necrotizing pancreatitis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2356.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43205","name":"Esophagus endoscopy/ligation","description":"Esophagoscopy, flexible, transoral; with band ligation of esophageal varices","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"75827","name":"Vein x-ray chest","description":"Venography, caval, superior, with serialography, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"J7516","name":"Inj, cyclosporine 250mg","description":"Injection, cyclosporine, 250 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0585","name":"Nebulizer w/ compressor & he","description":"Nebulizer, with compressor and heater","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"E1236","name":"Folding ped wc adjustable","description":"Wheelchair, pediatric size, folding, adjustable, with seating system","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82677","name":"Assay of estriol","description":"Estriol","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2776.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"47560","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43350","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1133.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["QB","RR","QF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":960.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95822","name":"Eeg coma or sleep only","description":"Electroencephalogram (eeg); recording in coma or sleep only","date_of_service":"2026-05-10","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":"Q2022","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88272","name":"Cytogenetics 3-5","description":"Molecular cytogenetics; chromosomal in situ hybridization, analyze 3-5 cells (eg, for derivatives and markers)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1130.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3969","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78015","name":"Thyroid met imaging","description":"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only)","date_of_service":"2026-05-10","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":"95979","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"26230","name":"Partial removal of hand bone","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis); metacarpal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29750","name":"Wedging of clubfoot cast","description":"Wedging of clubfoot cast","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43130","name":"Removal of esophagus pouch","description":"Diverticulectomy of hypopharynx or esophagus, with or without myotomy; cervical approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23130","name":"Acromp/acromionectomy prtl","description":"Acromioplasty or acromionectomy, partial, with or without coracoacromial ligament release","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":392.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"55605","name":"Vesiculotomy complicated","description":"Vesiculotomy; complicated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0783","name":"Programmable infusion pump","description":"Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"94690","name":"O2 uptk rest indirect","description":"Oxygen uptake, expired gas analysis; rest, indirect (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1905.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"J0715","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A7017","name":"Nebulizer not used w oxygen","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen","date_of_service":"2026-05-10","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":"32853","name":"Lung transplant double","description":"Lung transplant, double (bilateral sequential or en bloc); without cardiopulmonary bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3904.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82330","name":"Assay of calcium","description":"Calcium; ionized","date_of_service":"2026-05-10","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":"H0014","name":"Alcohol and/or drug services","description":"Alcohol and/or drug services; ambulatory detoxification","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"60210","name":"Partial thyroid excision","description":"Partial thyroid lobectomy, unilateral; with or without isthmusectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":789.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37201","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32422","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30300","name":"Remove nasal foreign body","description":"Removal foreign body, intranasal; office type procedure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4709","name":"Acid conc sol per gallon","description":"Acid concentrate, solution, for hemodialysis, per gallon","date_of_service":"2026-05-10","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":"86243","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":649.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"L3971","name":"Sewho cap design w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":833.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36002","name":"Pseudoaneurysm injection trt","description":"Injection procedures (eg, thrombin) for percutaneous treatment of extremity pseudoaneurysm","date_of_service":"2026-05-10","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":"A4422","name":"Ost pouch absorbent material","description":"Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"76511","name":"Oph us dx quan a-scan only","description":"Ophthalmic ultrasound, diagnostic; quantitative a-scan only","date_of_service":"2026-05-10","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":"85246","name":"Clot factor viii vw antigen","description":"Clotting; factor viii, vw factor antigen","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"79005","name":"Nuclear rx oral admin","description":"Radiopharmaceutical therapy, by oral administration","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["AV","AU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27441","name":"Revision of knee joint","description":"Arthroplasty, knee, tibial plateau; with debridement and partial synovectomy","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"33463","name":"Valvuloplasty tricuspid","description":"Valvuloplasty, tricuspid valve; without ring insertion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35341","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; mesenteric, celiac, or renal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"A7011","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"76101","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78805","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0166","name":"Granisetron hcl 1 mg oral","description":"Granisetron hydrochloride, 1 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 24 hour dosage regimen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"76970","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"47500","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1170","name":"Whlchr ampu fxd arm leg rest","description":"Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"36620","name":"Insertion catheter artery","description":"Arterial catheterization or cannulation for sampling, monitoring or transfusion (separate procedure); percutaneous","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"90806","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2223","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0462","name":"Rocking bed w/ or w/o side r","description":"Rocking bed with or without side rails","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1495.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"78140","name":"Red cell sequestration","description":"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"61501","name":"Craniectomy f/osteomyelitis","description":"Craniectomy; for osteomyelitis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1240.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1378.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50541","name":"Laparo ablate renal cyst","description":"Laparoscopy, surgical; ablation of renal cysts","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28086","name":"Excise foot tendon sheath","description":"Synovectomy, tendon sheath, foot; flexor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0012A","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96542","name":"Chemotherapy injection","description":"Chemotherapy injection, subarachnoid or intraventricular via subcutaneous reservoir, single or multiple agents","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"85520","name":"Heparin assay","description":"Heparin assay","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"73521","name":"X-ray exam hips bi 2 views","description":"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75705","name":"Artery x-rays spine","description":"Angiography, spinal, selective, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58340","name":"Catheter for hysterography","description":"Catheterization and introduction of saline or contrast material for saline infusion sonohysterography (sis) or hysterosalpingography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"32555","name":"Aspirate pleura w/ imaging","description":"Thoracentesis, needle or catheter, aspiration of the pleural space; with imaging guidance","date_of_service":"2026-05-10","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":"86653","name":"Encephaltis st louis antbody","description":"Antibody; encephalitis, st. louis","date_of_service":"2026-05-10","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":"83718","name":"Assay of lipoprotein","description":"Lipoprotein, direct measurement; high density cholesterol (hdl cholesterol)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"78018","name":"Thyroid met imaging body","description":"Thyroid carcinoma metastases imaging; whole body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"84585","name":"Assay of urine vma","description":"Vanillylmandelic acid (vma), urine","date_of_service":"2026-05-10","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":"37181","name":"Splice spleen/kidney veins","description":"Venous anastomosis, open; splenorenal, distal (selective decompression of esophagogastric varices, any technique)","date_of_service":"2026-05-10","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":"75722","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"44850","name":"Repair of mesentery","description":"Suture of mesentery (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":763.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1343.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73700","name":"Ct lower extremity w/o dye","description":"Computed tomography, lower extremity; without contrast material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90698","name":"Dtap-ipv/hib vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, haemophilus influenzae type b, and inactivated poliovirus vaccine, (dtap-ipv/hib), for intramuscular use","date_of_service":"2026-05-10","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":148.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25905","name":"Amputation of forearm","description":"Amputation, forearm, through radius and ulna; open, circular (guillotine)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"77776","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"49426","name":"Revise abdomen-venous shunt","description":"Revision of peritoneal-venous shunt","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"28140","name":"Removal of metatarsal","description":"Metatarsectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"90655","name":"Iiv3 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6255","name":"Absorpt drg >16<=48 in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7508","name":"Housing & integrated adhesiv","description":"Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2742.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"70100","name":"X-ray exam of jaw <4views","description":"Radiologic examination, mandible; partial, less than 4 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"46700","name":"Repair of anal stricture","description":"Anoplasty, plastic operation for stricture; adult","date_of_service":"2026-05-10","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":"82626","name":"Dehydroepiandrosterone","description":"Dehydroepiandrosterone (dhea)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76120","name":"Cine/video x-rays","description":"Cineradiography/videoradiography, except where specifically included","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","date_of_service":"2026-05-10","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":"64644","name":"Chemodenerv 1 extrem 5/> mus","description":"Chemodenervation of one extremity; 5 or more muscles","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75658","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94375","name":"Respiratory flow volume loop","description":"Respiratory flow volume loop","date_of_service":"2026-05-10","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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33670","name":"Repair of heart chambers","description":"Repair of complete atrioventricular canal, with or without prosthetic valve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1719.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42660","name":"Dilation of salivary duct","description":"Dilation and catheterization of salivary duct, with or without injection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01958","name":"Anes xtrnl cephalic version","description":"Anesthesia for external cephalic version procedure","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"38207","name":"Cryopreserve stem cells","description":"Transplant preparation of hematopoietic progenitor cells; cryopreservation and storage","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"25443","name":"Arthrp prostc dstl scph crpl","description":"Arthroplasty with prosthetic replacement; scaphoid carpal (navicular)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"20924","name":"Removal of tendon for graft","description":"Tendon graft, from a distance (eg, palmaris, toe extensor, plantaris)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":423.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":733.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46744","name":"Repair of cloacal anomaly","description":"Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, sacroperineal approach","date_of_service":"2026-05-10","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":"33665","name":"Repair of heart defects","description":"Repair of intermediate or transitional atrioventricular canal, with or without atrioventricular valve repair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25445","name":"Arthrp w/prostc trapezium","description":"Arthroplasty with prosthetic replacement; trapezium","date_of_service":"2026-05-10","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":"92603","name":"Cochlear implt f/up exam 7/>","description":"Diagnostic analysis of cochlear implant, age 7 years or older; with programming","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88323","name":"Consltj&reprt matrl prep sld","description":"Consultation and report on referred material requiring preparation of slides","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82977","name":"Assay of ggt","description":"Glutamyltransferase, gamma (ggt)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1364.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"J2275","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1249.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"93555","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"77761","name":"Apply intrcav radiat simple","description":"Intracavitary radiation source application; simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83858","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93545","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"64611","name":"Chemodenerv saliv glands","description":"Chemodenervation of parotid and submandibular salivary glands, bilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"97545","name":"Work hardening","description":"Work hardening/conditioning; initial 2 hours","date_of_service":"2026-05-10","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":"34530","name":"Leg vein fusion","description":"Saphenopopliteal vein anastomosis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":508.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-10","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":"0190T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"82664","name":"Electrophoretic test","description":"Electrophoretic technique, not elsewhere specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"87084","name":"Culture of specimen by kit","description":"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"50782","name":"Reimplant ureter in bladder","description":"Ureteroneocystostomy; anastomosis of duplicated ureter to bladder","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1310.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1890.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1114.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31601","name":"Planned tracheostomy<2 yrs","description":"Tracheostomy, planned (separate procedure); younger than 2 years","date_of_service":"2026-05-10","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":"00600","name":"Anes px crv spine&cord nos","description":"Anesthesia for procedures on cervical spine and cord; not otherwise specified","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88385","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"H0005","name":"Alcohol and/or drug services","description":"Alcohol and/or drug services; group counseling by a clinician","date_of_service":"2026-05-10","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":"14000","name":"Tis trnfr trunk 10 sq cm/<","description":"Adjacent tissue transfer or rearrangement, trunk; defect 10 sq cm or less","date_of_service":"2026-05-10","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":"G0204","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27407","name":"Repair of knee ligament","description":"Repair, primary, torn ligament and/or capsule, knee; cruciate","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77776","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"91112","name":"Gi wireless capsule measure","description":"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["26"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01190","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"19396","name":"Design custom breast implant","description":"Preparation of moulage for custom breast implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":995.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"83885","name":"Assay of nickel","description":"Nickel","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"91022","name":"Duodenal motility study","description":"Duodenal motility (manometric) study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5613","name":"Ak 4 bar ling w/hydraul swig","description":"Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"29876","name":"Arthrs knee surg synvct maj","description":"Arthroscopy, knee, surgical; synovectomy, major, 2 or more compartments (eg, medial or lateral)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":746.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86781","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3808","name":"Whfo, rigid w/o joints","description":"Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":"77310","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2383.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"26200","name":"Remove hand bone lesion","description":"Excision or curettage of bone cyst or benign tumor of metacarpal;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"54840","name":"Remove epididymis lesion","description":"Excision of spermatocele, with or without epididymectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85007","name":"Bl smear w/diff wbc count","description":"Blood count; blood smear, microscopic examination with manual differential wbc count","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3925","name":"Fo pip dip jnt/sprng pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"27612","name":"Exploration of ankle joint","description":"Arthrotomy, posterior capsular release, ankle, with or without achilles tendon lengthening","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":662.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"49429","name":"Removal of shunt","description":"Removal of peritoneal-venous shunt","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":528.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2231.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4432","name":"Os pch urine w bar/fange/tap","description":"Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82945","name":"Glucose other fluid","description":"Glucose, body fluid, other than blood","date_of_service":"2026-05-10","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":"33676","name":"Close mult vsd w/resection","description":"Closure of multiple ventricular septal defects; with pulmonary valvotomy or infundibular resection (acyanotic)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"53660","name":"Dilation of urethra","description":"Dilation of female urethra including suppository and/or instillation; initial","date_of_service":"2026-05-10","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":"52305","name":"Cystoscopy and treatment","description":"Cystourethroscopy; with incision or resection of orifice of bladder diverticulum, single or multiple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41806","name":"Removal foreign body jawbone","description":"Removal of embedded foreign body from dentoalveolar structures; bone","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82378","name":"Carcinoembryonic antigen","description":"Carcinoembryonic antigen (cea)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5613","name":"Ak 4 bar ling w/hydraul swig","description":"Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"33254","name":"Ablate atria lmtd","description":"Operative tissue ablation and reconstruction of atria, limited (eg, modified maze procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1170.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35693","name":"Art trnsposj subclavian","description":"Transposition and/or reimplantation; vertebral to subclavian artery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1135.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95907","name":"Nvr cndj tst 1-2 studies","description":"Nerve conduction studies; 1-2 studies","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1024.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"99302","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1062.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47553","name":"Biliary endoscopy thru skin","description":"Biliary endoscopy, percutaneous via t-tube or other tract; with biopsy, single or multiple","date_of_service":"2026-05-10","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":"95863","name":"Needle emg 3 extremities","description":"Needle electromyography; 3 extremities with or without related paraspinal areas","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-10","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":"71010","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"84144","name":"Assay of progesterone","description":"Progesterone","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":"E0316","name":"Bed safety enclosure","description":"Safety enclosure frame/canopy for use with hospital bed, any type","date_of_service":"2026-05-10","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":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","date_of_service":"2026-05-10","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":"E0171","name":"Commode chair non-electric","description":"Commode chair with integrated seat lift mechanism, non-electric, any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27445","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1507.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":"28222","name":"Release of foot tendons","description":"Tenolysis, flexor, foot; multiple tendons","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5679","name":"Socket insert w/o lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism","date_of_service":"2026-05-10","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":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"55150","name":"Removal of scrotum","description":"Resection of scrotum","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"27530","name":"Treat knee fracture","description":"Closed treatment of tibial fracture, proximal (plateau); without manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33412","name":"Replacement of aortic valve","description":"Replacement, aortic valve; with transventricular aortic annulus enlargement (konno procedure)","date_of_service":"2026-05-10","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":"42409","name":"Drainage of salivary cyst","description":"Marsupialization of sublingual salivary cyst (ranula)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23066","name":"Biopsy shoulder tissues","description":"Biopsy, soft tissue of shoulder area; deep","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68100","name":"Biopsy conjunctiva","description":"Biopsy of conjunctiva","date_of_service":"2026-05-10","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":"90375","name":"Rabies ig im/sc","description":"Rabies immune globulin (rig), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","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":62.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28675","name":"Repair of toe dislocation","description":"Open treatment of interphalangeal joint dislocation, includes internal fixation, when performed","date_of_service":"2026-05-10","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":"84586","name":"Assay of vip","description":"Vasoactive intestinal peptide (vip)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2618","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1563.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87517","name":"Hepatitis b dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); hepatitis b virus, quantification","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2208","name":"Lens sphcy bifocal 4.25-7/2.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"76519","name":"Echo exam of eye","description":"Ophthalmic biometry by ultrasound echography, a-scan; with intraocular lens power calculation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"97150","name":"Group therapeutic procedures","description":"Therapeutic procedure(s), group (2 or more individuals)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28630","name":"Treat toe dislocation","description":"Closed treatment of metatarsophalangeal joint dislocation; without anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"70150","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; complete, minimum of 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"K1007","name":"Bil hkaf pc s/d micro sensor","description":"Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25392","name":"Shorten radius & ulna","description":"Osteoplasty, radius and ulna; shortening (excluding 64876)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"94400","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1925.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93040","name":"Rhythm ecg with report","description":"Rhythm ecg, 1-3 leads; with interpretation and report","date_of_service":"2026-05-10","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":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"32120","name":"Re-exploration of chest","description":"Thoracotomy; for postoperative complications","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":910.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"83921","name":"Organic acid single quant","description":"Organic acid, single, quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L4350","name":"Ankle control ortho pre ots","description":"Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0623","name":"Sio rig pnl pelv/sac pre ots","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2106","name":"Afo tib fx cast plaster mold","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24576","name":"Cltx humrl cndylr fx wo mnpj","description":"Closed treatment of humeral condylar fracture, medial or lateral; without manipulation","date_of_service":"2026-05-10","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":"99170","name":"Anogenital exam child w imag","description":"Anogenital examination, magnified, in childhood for suspected trauma, including image recording when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"89141","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90853","name":"Group psychotherapy","description":"Group psychotherapy (other than of a multiple-family group)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70150","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; complete, minimum of 3 views","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70300","name":"X-ray exam of teeth","description":"Radiologic examination, teeth; single view","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90824","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"71130","name":"X-ray strenoclavic jt 3/>vws","description":"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"24000","name":"Arthrt elbw expl drg/rmvl fb","description":"Arthrotomy, elbow, including exploration, drainage, or removal of foreign body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1630","name":"Abduct control hip semi-flex","description":"Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32220","name":"Release of lung","description":"Decortication, pulmonary (separate procedure); total","date_of_service":"2026-05-10","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":"20979","name":"Lw ntsty us stimj bone healg","description":"Low intensity ultrasound stimulation to aid bone healing, noninvasive (nonoperative)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"73500","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99217","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88108","name":"Cytopath concentrate tech","description":"Cytopathology, concentration technique, smears and interpretation (eg, saccomanno technique)","date_of_service":"2026-05-10","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":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93315","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1070","name":"Wheelchair detachable foot r","description":"Fully-reclining wheelchair, detachable arms (desk or full length) swing away detachable footrest","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6254","name":"Absorpt drg <=16 sq in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"96002","name":"Dynamic surface emg","description":"Dynamic surface electromyography, during walking or other functional activities, 1-12 muscles","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41110","name":"Excision of tongue lesion","description":"Excision of lesion of tongue without closure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KF"]}],"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":"2026-05-10","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":"55041","name":"Removal of hydroceles","description":"Excision of hydrocele; bilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-10","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":"26450","name":"Incision of palm tendon","description":"Tenotomy, flexor, palm, open, each tendon","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6975","name":"Interscap-thor myoelectronic","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"78226","name":"Hepatobiliary system imaging","description":"Hepatobiliary system imaging, including gallbladder when present;","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"31238","name":"Nsl/sins ndsc srg nsl hemrrg","description":"Nasal/sinus endoscopy, surgical; with control of nasal hemorrhage","date_of_service":"2026-05-10","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":"L5510","name":"Prep bk ptb plaster molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70150","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; complete, minimum of 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"89050","name":"Body fluid cell count","description":"Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except blood;","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-10","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":"L5973","name":"Ank-foot sys dors-plant flex","description":"Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8476.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"45805","name":"Repair fistula w/colostomy","description":"Closure of rectovesical fistula; with colostomy","date_of_service":"2026-05-10","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":"88342","name":"Imhchem/imcytchm 1st antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"85420","name":"Fibrinolytic plasminogen","description":"Fibrinolytic factors and inhibitors; plasminogen, except antigenic assay","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6214","name":"Foam drg > 48 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-10","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":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95920","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27331","name":"Explore/treat knee joint","description":"Arthrotomy, knee; including joint exploration, biopsy, or removal of loose or foreign bodies","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75980","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74220","name":"X-ray xm esophagus 1cntrst","description":"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27647","name":"Resect talus/calcaneus tum","description":"Radical resection of tumor; talus or calcaneus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":798.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93618","name":"Indctj arrhythmia elec pacg","description":"Induction of arrhythmia by electrical pacing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2251","name":"Brief chkin, 5-10, non-e/m","description":"Brief communication technology-based service, e.g. virtual check-in, by a qualified health care professional who cannot report evaluation and management services, provided to an established patient, not originating from a related service provided within the previous 7 days nor leading to a service o","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"95904","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82985","name":"Assay of glycated protein","description":"Glycated protein","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"37223","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64402","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"45110","name":"Removal of rectum","description":"Proctectomy; complete, combined abdominoperineal, with colostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"75954","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"L0210","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52500","name":"Trurl resection bladder neck","description":"Transurethral resection of bladder neck (separate procedure)","date_of_service":"2026-05-10","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":"E1800","name":"Adjust elbow ext & flex dev","description":"Dynamic adjustable elbow extension and flexion device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"E0200","name":"Heat lamp without stand","description":"Heat lamp, without stand (table model), includes bulb, or infrared element","date_of_service":"2026-05-10","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":"78350","name":"Bone mineral single photon","description":"Bone density (bone mineral content) study, 1 or more sites; single photon absorptiometry","date_of_service":"2026-05-10","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":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0433","name":"Portable liquid oxygen sys","description":"Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-10","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":"66986","name":"Exchange lens prosthesis","description":"Exchange of intraocular lens","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38770","name":"Remove pelvis lymph nodes","description":"Pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78261","name":"Gastric mucosa imaging","description":"Gastric mucosa imaging","date_of_service":"2026-05-10","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":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1303.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44025","name":"Incision of large bowel","description":"Colotomy, for exploration, biopsy(s), or foreign body removal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":982.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1058.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2035","name":"Kafo plastic pediatric size","description":"Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"29916","name":"Hip arthro w/labral repair","description":"Arthroscopy, hip, surgical; with labral repair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","date_of_service":"2026-05-10","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":"E1821","name":"Replacement interface spsd","description":"Replacement soft interface material/cuffs for bi-directional static progressive stretch device","date_of_service":"2026-05-10","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":"23150","name":"Removal of humerus lesion","description":"Excision or curettage of bone cyst or benign tumor of proximal humerus;","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82150","name":"Assay of amylase","description":"Amylase","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-05-10","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":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92526","name":"Oral function therapy","description":"Treatment of swallowing dysfunction and/or oral function for feeding","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87076","name":"Culture anaerobe ident each","description":"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0275","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"A4755","name":"Comb art/venous blood tubing","description":"Blood tubing, arterial and venous combined, for hemodialysis, each","date_of_service":"2026-05-10","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":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":526.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0358T","name":"Bia whole body","description":"Bioelectrical impedance analysis whole body composition assessment, with interpretation and report","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84244","name":"Assay of renin","description":"Renin","date_of_service":"2026-05-10","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":"00222","name":"Anes icr px ecoag icr nrv","description":"Anesthesia for intracranial procedures; electrocoagulation of intracranial nerve","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"ATP18","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"S3818","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"46761","name":"Repair of anal sphincter","description":"Sphincteroplasty, anal, for incontinence, adult; levator muscle imbrication (park posterior anal repair)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":938.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"91120","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"L8631","name":"Mcp joint repl 2 pc or more","description":"Metacarpal phalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes entire system)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","date_of_service":"2026-05-10","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":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":761.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1038","name":"Transport chair pt wt<=300lb","description":"Transport chair, adult size, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q2019","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1476.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"82105","name":"Alpha-fetoprotein serum","description":"Alpha-fetoprotein (afp); serum","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1353.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1953.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2926.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33889","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1033.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":565.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"B4104","name":"Additive for enteral formula","description":"Additive for enteral formula (e.g., fiber)","date_of_service":"2026-05-10","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":"93510","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2226.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"70350","name":"X-ray head for orthodontia","description":"Cephalogram, orthodontic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"86215","name":"Deoxyribonuclease antibody","description":"Deoxyribonuclease, antibody","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3343.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29907","name":"Subtalar arthro w/fusion","description":"Arthroscopy, subtalar joint, surgical; with subtalar arthrodesis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":740.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82946","name":"Glucagon tolerance test","description":"Glucagon tolerance test","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01860","name":"Anes forearm wrist/hand cast","description":"Anesthesia for forearm, wrist, or hand cast application, removal, or repair","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0204","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51736","name":"Urine flow measurement","description":"Simple uroflowmetry (ufr) (eg, stop-watch flow rate, mechanical uroflowmeter)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88230","name":"Tissue culture lymphocyte","description":"Tissue culture for non-neoplastic disorders; lymphocyte","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"61870","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"33813","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1560.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1382.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35565","name":"Art byp grft iliofemoral","description":"Bypass graft, with vein; iliofemoral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1635.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40844","name":"Reconstruction of mouth","description":"Vestibuloplasty; entire arch","date_of_service":"2026-05-10","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":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77073","name":"Bone length studies","description":"Bone length studies (orthoroentgenogram, scanogram)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82523","name":"Collagen crosslinks","description":"Collagen cross links, any method","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78588","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2050","name":"Hkafo torsion cable hip pelv","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2387.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45355","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"31587","name":"Laryngoplasty cricoid split","description":"Laryngoplasty, cricoid split, without graft placement","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":994.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78468","name":"Heart infarct image (ef)","description":"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78230","name":"Salivary gland imaging","description":"Salivary gland imaging;","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78201","name":"Liver imaging static only","description":"Liver imaging; static only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6231","name":"Hydrogel dsg<=16 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"32440","name":"Remove lung pneumonectomy","description":"Removal of lung, pneumonectomy;","date_of_service":"2026-05-10","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":"27335","name":"Remove knee joint lining","description":"Arthrotomy, with synovectomy, knee; anterior and posterior including popliteal area","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"89329","name":"Sperm evaluation test","description":"Sperm evaluation; hamster penetration test","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"T4523","name":"Adult size brief/diaper lg","description":"Adult sized disposable incontinence product, brief/diaper, large, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"34802","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"80164","name":"Assay dipropylacetic acd tot","description":"Valproic acid (dipropylacetic acid); total","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56700","name":"Prtl hymnctmy/revj hymnl rng","description":"Partial hymenectomy or revision of hymenal ring","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"46746","name":"Repair of cloacal anomaly","description":"Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, combined abdominal and sacroperineal approach;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4056.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0840","name":"Tract frame attach headboard","description":"Traction frame, attached to headboard, cervical traction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"00537","name":"Anes cardiac ep procedures","description":"Anesthesia for cardiac electrophysiologic procedures including radiofrequency ablation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"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":"67550","name":"Insert eye socket implant","description":"Orbital implant (implant outside muscle cone); insertion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31572","name":"Largsc w/laser dstrj les","description":"Laryngoscopy, flexible; with ablation or destruction of lesion(s) with laser, unilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0634","name":"Lso flexion control custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, c","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"82140","name":"Assay of ammonia","description":"Ammonia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":997.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77416","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95866","name":"Needle emg hemidiaphragm","description":"Needle electromyography; hemidiaphragm","date_of_service":"2026-05-10","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":"61612","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3766","name":"Ewhfo w/joint(s) cf","description":"Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33600","name":"Closure of valve","description":"Closure of atrioventricular valve (mitral or tricuspid) by suture or patch","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"36831","name":"Open thrombect av fistula","description":"Thrombectomy, open, arteriovenous fistula without revision, autogenous or nonautogenous dialysis graft (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":583.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"35301","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; carotid, vertebral, subclavian, by neck incision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27391","name":"Incision of thigh tendons","description":"Tenotomy, open, hamstring, knee to hip; multiple tendons, 1 leg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85555","name":"Rbc osmotic fragility","description":"Osmotic fragility, rbc; unincubated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29827","name":"Sho arthrs srg rt8tr cuf rpr","description":"Arthroscopy, shoulder, surgical; with rotator cuff repair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1347.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83901","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"69300","name":"Revise external ear","description":"Otoplasty, protruding ear, with or without size reduction","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"29868","name":"Meniscal trnspl knee w/scpe","description":"Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for meniscal insertion), medial or lateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L1990","name":"Afo doub solid stirrup calf","description":"Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar bk orthosis), custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25680","name":"Cltx trns-scphprlnr fx mnpj","description":"Closed treatment of trans-scaphoperilunar type of fracture dislocation, with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":517.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1460","name":"Gamma globulin 1 cc inj","description":"Injection, gamma globulin, intramuscular, 1 cc","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"35875","name":"Removal of clot in graft","description":"Thrombectomy of arterial or venous graft (other than hemodialysis graft or fistula);","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20838","name":"Replantation foot complete","description":"Replantation, foot, complete amputation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2805.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"27290","name":"Amputation of leg at hip","description":"Interpelviabdominal amputation (hindquarter amputation)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","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":"93721","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"91132","name":"Electrogastrography","description":"Electrogastrography, diagnostic, transcutaneous;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6254","name":"Absorpt drg <=16 sq in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1912.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00810","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"84578","name":"Test urine urobilinogen","description":"Urobilinogen, urine; qualitative","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6222","name":"Gauze <=16 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0706","name":"Caffeine citrate injection","description":"Injection, caffeine citrate, 5 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2543","name":"Piperacillin/tazobactam","description":"Injection, piperacillin sodium/tazobactam sodium, 1 gram/0.125 grams (1.125 grams)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35221","name":"Rpr bld vsl dir intra-abdl","description":"Repair blood vessel, direct; intra-abdominal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1675.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"82693","name":"Assay of ethylene glycol","description":"Ethylene glycol","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4300.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9305","name":"Inj. pemetrexed nos 10mg","description":"Injection, pemetrexed, not otherwise specified, 10 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"40814","name":"Excise/repair mouth lesion","description":"Excision of lesion of mucosa and submucosa, vestibule of mouth; with complex repair","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0638","name":"Lso sag-coronal panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29505","name":"Application long leg splint","description":"Application of long leg splint (thigh to ankle or toes)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2312","name":"Lens sphc trifo 7.25-12/2.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"25820","name":"Arthrd wrist lmtd w/o b1 grf","description":"Arthrodesis, wrist; limited, without bone graft (eg, intercarpal or radiocarpal)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0633","name":"Lso sc r pos/lat pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","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":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"43453","name":"Dilate esophagus","description":"Dilation of esophagus, over guide wire","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76827","name":"Echo exam of fetal heart","description":"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86665","name":"Epstein-barr capsid vca","description":"Antibody; epstein-barr (eb) virus, viral capsid (vca)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.6,"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":"37208","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"20912","name":"Remove cartilage for graft","description":"Cartilage graft; nasal septum","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88738","name":"Hgb quant transcutaneous","description":"Hemoglobin (hgb), quantitative, transcutaneous","date_of_service":"2026-05-10","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":"92541","name":"Spontaneous nystagmus test","description":"Spontaneous nystagmus test, including gaze and fixation nystagmus, with recording","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92953","name":"Temporary external pacing","description":"Temporary transcutaneous pacing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"92265","name":"Ndl oculoelectromyography 1+","description":"Needle oculoelectromyography, 1 or more extraocular muscles, 1 or both eyes, with interpretation and report","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26170","name":"Removal of palm tendon each","description":"Excision of tendon, palm, flexor or extensor, single, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["26"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2927.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"82310","name":"Assay of calcium","description":"Calcium; total","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"73540","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31526","name":"Dx laryngoscopy w/oper scope","description":"Laryngoscopy direct, with or without tracheoscopy; diagnostic, with operating microscope or telescope","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"64585","name":"Rev/rmv perph nstim eltrd ra","description":"Revision or removal of peripheral neurostimulator electrode array","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67560","name":"Revise eye socket implant","description":"Orbital implant (implant outside muscle cone); removal or revision","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1640","name":"Pelv band/spread bar thigh c","description":"Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0113","name":"Pinworm examinations","description":"Pinworm examinations","date_of_service":"2026-05-10","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":"15788","name":"Chemical peel facial epidrm","description":"Chemical peel, facial; epidermal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":604.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0172","name":"Cerv col sr foam 2pc pre ots","description":"Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5648","name":"Above knee cushion socket","description":"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"72190","name":"X-ray exam of pelvis","description":"Radiologic examination, pelvis; complete, minimum of 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"87557","name":"M.tuberculo dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria tuberculosis, quantification","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9280","name":"Mitomycin injection","description":"Injection, mitomycin, 5 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95831","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"95957","name":"Eeg digital analysis","description":"Digital analysis of electroencephalogram (eeg) (eg, for epileptic spike analysis)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68510","name":"Biopsy of tear gland","description":"Biopsy of lacrimal gland","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71110","name":"X-ray exam ribs bil 3 views","description":"Radiologic examination, ribs, bilateral; 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"65091","name":"Revise eye","description":"Evisceration of ocular contents; without implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44500","name":"Intro gastrointestinal tube","description":"Introduction of long gastrointestinal tube (eg, miller-abbott) (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77520","name":"Proton trmt simple w/o comp","description":"Proton treatment delivery; simple, without compensation","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"82486","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"61702","name":"Inner skull vessel surgery","description":"Surgery of simple intracranial aneurysm, intracranial approach; vertebrobasilar circulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0250","name":"Hosp bed fixed ht w/ mattres","description":"Hospital bed, fixed height, with any type side rails, with mattress","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"C1768","name":"Graft, vascular","description":"Graft, vascular","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35321","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; axillary-brachial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1146.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","date_of_service":"2026-05-10","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":"66850","name":"Removal of lens material","description":"Removal of lens material; phacofragmentation technique (mechanical or ultrasonic) (eg, phacoemulsification), with aspiration","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":761.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49600","name":"Repair umbilical lesion","description":"Repair of small omphalocele, with primary closure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3915","name":"Who nontorsion jnts pre cst","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0737","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"E0460","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9130","name":"Dacarbazine 100 mg inj","description":"Dacarbazine, 100 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59012","name":"Fetal cord puncture prenatal","description":"Cordocentesis (intrauterine), any method","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28055","name":"Neurectomy foot","description":"Neurectomy, intrinsic musculature of foot","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"58323","name":"Sperm washing","description":"Sperm washing for artificial insemination","date_of_service":"2026-05-10","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":"75807","name":"Lymph vessel x-ray trunk","description":"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84545","name":"Urea-n clearance test","description":"Urea nitrogen, clearance","date_of_service":"2026-05-10","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":"31230","name":"Removal of upper jaw","description":"Maxillectomy; with orbital exenteration (en bloc)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1931.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"G6002","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6231","name":"Hydrogel dsg<=16 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing","date_of_service":"2026-05-10","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":"T4526","name":"Adult size pull-on med","description":"Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each","date_of_service":"2026-05-10","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":"78647","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84481","name":"Free assay (ft-3)","description":"Triiodothyronine t3; free","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1641.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"81284","name":"Fxn gene detc abnor alleles","description":"Fxn (frataxin) (eg, friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44125","name":"Removal of small intestine","description":"Enterectomy, resection of small intestine; with enterostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76831","name":"Echo exam uterus","description":"Saline infusion sonohysterography (sis), including color flow doppler, when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2120","name":"Pulse gen sys tx endolymp fl","description":"Pulse generator system for tympanic treatment of inner ear endolymphatic fluid","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2220","name":"Dorsi & plantar flex ass/res","description":"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4211.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-10","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":"53460","name":"Revision of urethra","description":"Urethromeatoplasty, with partial excision of distal urethral segment (richardson type procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"93581","name":"Transcath closure of vsd","description":"Percutaneous transcatheter closure of a congenital ventricular septal defect with implant","date_of_service":"2026-05-10","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":"61520","name":"Removal of brain lesion","description":"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; cerebellopontine angle tumor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86625","name":"Campylobacter antibody","description":"Antibody; campylobacter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54820","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1186.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"94750","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"32310","name":"Removal of chest lining","description":"Pleurectomy, parietal (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1023.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"15822","name":"Blepharoplasty upper eyelid","description":"Blepharoplasty, upper eyelid;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80186","name":"Assay of phenytoin free","description":"Phenytoin; free","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31320","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1321.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"76096","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2134","name":"Kafo fem fx cast semi-rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"45380","name":"Colonoscopy and biopsy","description":"Colonoscopy, flexible; with biopsy, single or multiple","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"01756","name":"Anes opn/arthrs elbw rad px","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; radical procedures","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","date_of_service":"2026-05-10","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":"52353","name":"Cystouretero w/lithotripsy","description":"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1980","name":"Afo sing solid stirrup calf","description":"Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar bk orthosis), custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6925","name":"Wrist disart myoelectronic c","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2755","name":"Carbon graphite lamination","description":"Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"61522","name":"Removal of brain abscess","description":"Craniectomy, infratentorial or posterior fossa; for excision of brain abscess","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2006.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26474","name":"Fusion of finger tendons","description":"Tenodesis; of distal joint, each joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":514.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78282","name":"Gi protein loss","description":"Gastrointestinal protein loss","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4313","name":"Catheter w/bag 3-way","description":"Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"E0220","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21086","name":"Impres&prep auricular prosth","description":"Impression and custom preparation; auricular prosthesis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2180.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3457.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"93602","name":"Intra-atrial recording","description":"Intra-atrial recording","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"3077F","name":"Syst bp >= 140 mm hg","description":"Most recent systolic blood pressure greater than or equal to 140 mm hg (htn, ckd, cad) (dm)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"15335","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"G0107","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":514.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00754","name":"Anes hrna rpr omphalocele","description":"Anesthesia for hernia repairs in upper abdomen; omphalocele","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77076","name":"Radex osseous survey infant","description":"Radiologic examination, osseous survey, infant","date_of_service":"2026-05-10","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":"93978","name":"Vascular study","description":"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"56405","name":"I&d vulva/perineal abscess","description":"Incision and drainage of vulva or perineal abscess","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82668","name":"Assay of erythropoietin","description":"Erythropoietin","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","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":"89235","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49654","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59510","name":"Cesarean delivery","description":"Routine obstetric care including antepartum care, cesarean delivery, and postpartum care","date_of_service":"2026-05-10","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":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"66740","name":"Destruction ciliary body","description":"Ciliary body destruction; cyclodialysis","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4360","name":"Pneumat walking boot pre cst","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25031","name":"I&d forearm&/wrist bursa","description":"Incision and drainage, forearm and/or wrist; bursa","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"15940","name":"Exc ischial pr ulc prim sutr","description":"Excision, ischial pressure ulcer, with primary suture;","date_of_service":"2026-05-10","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":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","date_of_service":"2026-05-10","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":"27520","name":"Treat kneecap fracture","description":"Closed treatment of patellar fracture, without manipulation","date_of_service":"2026-05-10","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":"36825","name":"Artery-vein autograft","description":"Creation of arteriovenous fistula by other than direct arteriovenous anastomosis (separate procedure); autogenous graft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-10","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":"27350","name":"Removal of kneecap","description":"Patellectomy or hemipatellectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":769.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1697.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1227","name":"Wheelchair spec sz spec ht a","description":"Special height arms for wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":647.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","date_of_service":"2026-05-10","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":"26608","name":"Treat metacarpal fracture","description":"Percutaneous skeletal fixation of metacarpal fracture, each bone","date_of_service":"2026-05-10","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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"L3921","name":"Hfo w/joint(s) cf","description":"Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"29837","name":"Elbow arthroscopy/surgery","description":"Arthroscopy, elbow, surgical; debridement, limited","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":649.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"40700","name":"Repair cleft lip/nasal","description":"Plastic repair of cleft lip/nasal deformity; primary, partial or complete, unilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1012.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3044.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42000","name":"Drainage mouth roof lesion","description":"Drainage of abscess of palate, uvula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76820","name":"Umbilical artery echo","description":"Doppler velocimetry, fetal; umbilical artery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38308","name":"Incision of lymph channels","description":"Lymphangiotomy or other operations on lymphatic channels","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"92977","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1469.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-05-10","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":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77056","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31241","name":"Nsl/sns ndsc lig sphnptn art","description":"Nasal/sinus endoscopy, surgical; with ligation of sphenopalatine artery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"76080","name":"X-ray exam of fistula","description":"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92980","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99148","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"72131","name":"Ct lumbar spine w/o dye","description":"Computed tomography, lumbar spine; without contrast material","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63195","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"83835","name":"Assay of metanephrines","description":"Metanephrines","date_of_service":"2026-05-10","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":"E2223","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"25670","name":"Optx rdcrpl/ntrcrpl dislc 1+","description":"Open treatment of radiocarpal or intercarpal dislocation, 1 or more bones","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1584.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86689","name":"Htlv/hiv confirmj antibody","description":"Antibody; htlv or hiv antibody, confirmatory test (eg, western blot)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"00140","name":"Anes procedures on eye nos","description":"Anesthesia for procedures on eye; not otherwise specified","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-10","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":"15335","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":"93501","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"92612","name":"Endoscopy swallow (fees) vid","description":"Flexible endoscopic evaluation of swallowing by cine or video recording;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50948","name":"Laparo new ureter/bladder","description":"Laparoscopy, surgical; ureteroneocystostomy without cystoscopy and ureteral stent placement","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6220","name":"Gauze >16 <=48 sq in w/bordr","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78730","name":"Urinary bladder retention","description":"Urinary bladder residual study (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24332","name":"Tenolysis triceps","description":"Tenolysis, triceps","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":706.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86635","name":"Coccidioides antibody","description":"Antibody; coccidioides","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"75956","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"86310","name":"Heterophile antibody absrbj","description":"Heterophile antibodies; titers after absorption with beef cells and guinea pig kidney","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"00170","name":"Anes intraoral px nos","description":"Anesthesia for intraoral procedures, including biopsy; not otherwise specified","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6403","name":"Sterile gauze>16 <= 48 sq in","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73620","name":"X-ray exam of foot","description":"Radiologic examination, foot; 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35741","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74355","name":"X-ray guide intestinal tube","description":"Percutaneous placement of enteroclysis tube, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"75960","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"83905","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"33702","name":"Repair of heart defects","description":"Repair sinus of valsalva fistula, with cardiopulmonary bypass;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1341.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2604.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0344","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3764","name":"Ewho w/joint(s) cf","description":"Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"90733","name":"Mpsv4 vaccine subq","description":"Meningococcal polysaccharide vaccine, serogroups a, c, y, w-135, quadrivalent (mpsv4), for subcutaneous use","date_of_service":"2026-05-10","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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"69605","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"93615","name":"Esophageal recording","description":"Esophageal recording of atrial electrogram with or without ventricular electrogram(s);","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E1150","name":"Wheelchair standard w/ leg r","description":"Wheelchair, detachable arms, desk or full length swing away detachable elevating legrests","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"S8424","name":"Ready gradient sleeve","description":"Gradient pressure aid (sleeve), ready made","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"56805","name":"Clitoroplasty intersex state","description":"Clitoroplasty for intersex state","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1351.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76091","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3925","name":"Fo pip dip jnt/sprng pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2929.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58559","name":"Hysteroscopy lysis","description":"Hysteroscopy, surgical; with lysis of intrauterine adhesions (any method)","date_of_service":"2026-05-10","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":"64865","name":"Repair of facial nerve","description":"Suture of facial nerve; infratemporal, with or without grafting","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":889.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01958","name":"Anes xtrnl cephalic version","description":"Anesthesia for external cephalic version procedure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"47000","name":"Needle biopsy of liver perq","description":"Biopsy of liver, needle; percutaneous","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"95900","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"00873","name":"Anes lithotrp esw wo wtr bth","description":"Anesthesia for lithotripsy, extracorporeal shock wave; without water bath","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43030","name":"Cricopharyngeal myotomy","description":"Cricopharyngeal myotomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61000","name":"Remove cranial cavity fluid","description":"Subdural tap through fontanelle, or suture, infant, unilateral or bilateral; initial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83858","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"82205","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1161.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"82492","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"21805","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72198","name":"Mr angio pelvis w/o & w/dye","description":"Magnetic resonance angiography, pelvis, with or without contrast material(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42810","name":"Excision of neck cyst","description":"Excision branchial cleft cyst or vestige, confined to skin and subcutaneous tissues","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3465","name":"Injection, voriconazole","description":"Injection, voriconazole, 10 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"64792","name":"Removal of nerve lesion","description":"Excision of neurofibroma or neurolemmoma; extensive (including malignant type)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1181.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80299","name":"Quantitative assay drug","description":"Quantitation of therapeutic drug, not elsewhere specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"48020","name":"Removal of pancreatic stone","description":"Removal of pancreatic calculus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"40840","name":"Reconstruction of mouth","description":"Vestibuloplasty; anterior","date_of_service":"2026-05-10","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":"45386","name":"Colonoscopy w/balloon dilat","description":"Colonoscopy, flexible; with transendoscopic balloon dilation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3030","name":"Sumatriptan succinate / 6 mg","description":"Injection, sumatriptan succinate, 6 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"39531","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"95117","name":"Immunotherapy injections","description":"Professional services for allergen immunotherapy not including provision of allergenic extracts; 2 or more injections","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"31620","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":"92585","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76977","name":"Us bone density measure","description":"Ultrasound bone density measurement and interpretation, peripheral site(s), any method","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70300","name":"X-ray exam of teeth","description":"Radiologic examination, teeth; single view","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"64912","name":"Nrv rpr w/nrv algrft 1st","description":"Nerve repair; with nerve allograft, each nerve, first strand (cable)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"61610","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2334.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72040","name":"X-ray exam neck spine 2-3 vw","description":"Radiologic examination, spine, cervical; 2 or 3 views","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5673","name":"Socket insert w lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"25151","name":"Partial removal of radius","description":"Partial excision (craterization, saucerization, or diaphysectomy) of bone (eg, for osteomyelitis); radius","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"92614","name":"Laryngoscopic sensory vid","description":"Flexible endoscopic evaluation, laryngeal sensory testing by cine or video recording;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":"56800","name":"Plastic repair introitus","description":"Plastic repair of introitus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01650","name":"Anes art sho&ax nos","description":"Anesthesia for procedures on arteries of shoulder and axilla; not otherwise specified","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":802.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":847.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6203","name":"Composite drsg <= 16 sq in","description":"Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"30915","name":"Ligation nasal sinus artery","description":"Ligation arteries; ethmoidal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":649.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6402","name":"Sterile gauze <= 16 sq in","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92326","name":"Replacement of contact lens","description":"Replacement of contact lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2126.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0300","name":"Enclosed ped crib hosp grade","description":"Pediatric crib, hospital grade, fully enclosed, with or without top enclosure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85307","name":"Assay activated protein c","description":"Activated protein c (apc) resistance assay","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":717.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"00844","name":"Anes iper px abdmnprnl rescj","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; abdominoperineal resection","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1272.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"J1455","name":"Foscarnet sodium injection","description":"Injection, foscarnet sodium, per 1000 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3657.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"39561","name":"Resect diaphragm complex","description":"Resection, diaphragm; with complex repair (eg, prosthetic material, local muscle flap)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1309.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2627","name":"Plastic mold recipro hip & c","description":"Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","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":"97001","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":997.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"82649","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88262","name":"Chromosome analysis 15-20","description":"Chromosome analysis; count 15-20 cells, 2 karyotypes, with banding","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00164","name":"Anes px nose&sins bx sft tis","description":"Anesthesia for procedures on nose and accessory sinuses; biopsy, soft tissue","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-10","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":"86603","name":"Adenovirus antibody","description":"Antibody; adenovirus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00922","name":"Anes px male gent sem ves","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); seminal vesicles","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":665.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2410.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24330","name":"Flexor-plasty elbow","description":"Flexor-plasty, elbow (eg, steindler type advancement);","date_of_service":"2026-05-10","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":"36597","name":"Reposition venous catheter","description":"Repositioning of previously placed central venous catheter under fluoroscopic guidance","date_of_service":"2026-05-10","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":"13101","name":"Cmplx rpr trunk 2.6-7.5 cm","description":"Repair, complex, trunk; 2.6 cm to 7.5 cm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78807","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9512","name":"Tc99m pertechnetate","description":"Technetium tc-99m pertechnetate, diagnostic, per millicurie","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00524","name":"Anes clsd ch px pneumocents","description":"Anesthesia for closed chest procedures; pneumocentesis","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"85555","name":"Rbc osmotic fragility","description":"Osmotic fragility, rbc; unincubated","date_of_service":"2026-05-10","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":"77761","name":"Apply intrcav radiat simple","description":"Intracavitary radiation source application; simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70190","name":"X-ray exam of eye sockets","description":"Radiologic examination; optic foramina","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3219","name":"Orthopedic mens shoes oxford","description":"Orthopedic footwear, mens shoe, oxford, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77053","name":"X-ray of mammary duct","description":"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69806","name":"Explore inner ear","description":"Endolymphatic sac operation; with shunt","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1093.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L8687","name":"Implt nrostm pls gen dua rec","description":"Implantable neurostimulator pulse generator, dual array, rechargeable, includes extension","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8288.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00192","name":"Anes px fcl b1/skl rad surg","description":"Anesthesia for procedures on facial bones or skull; radical surgery (including prognathism)","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1296.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E1295","name":"Wheelchair heavy duty fixed","description":"Heavy duty wheelchair, fixed full length arms, elevating legrest","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"29847","name":"Wrist arthroscopy/surgery","description":"Arthroscopy, wrist, surgical; internal fixation for fracture or instability","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26433","name":"Repair finger tendon","description":"Repair of extensor tendon, distal insertion, primary or secondary; without graft (eg, mallet finger)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15401","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"82075","name":"Assay of breath ethanol","description":"Alcohol (ethanol); breath","date_of_service":"2026-05-10","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":"63271","name":"Excise intrspinl lesion thrc","description":"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; thoracic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2264.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"72120","name":"X-ray bend only l-s spine","description":"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views","date_of_service":"2026-05-10","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":"95875","name":"Limb exercise test","description":"Ischemic limb exercise test with serial specimen(s) acquisition for muscle(s) metabolite(s)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"45123","name":"Partial proctectomy","description":"Proctectomy, partial, without anastomosis, perineal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0373","name":"Nonpowered pressure mattress","description":"Nonpowered advanced pressure reducing mattress","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"38760","name":"Remove groin lymph nodes","description":"Inguinofemoral lymphadenectomy, superficial, including cloquets node (separate procedure)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q2014","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":876.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88291","name":"Cyto/molecular report","description":"Cytogenetics and molecular cytogenetics, interpretation and report","date_of_service":"2026-05-10","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":"47780","name":"Fuse bile ducts and bowel","description":"Anastomosis, roux-en-y, of extrahepatic biliary ducts and gastrointestinal tract","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84375","name":"Chromatogram assay sugars","description":"Sugars, chromatographic, tlc or paper chromatography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45345","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"G0507","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"37233","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27040","name":"Biopsy of soft tissues","description":"Biopsy, soft tissue of pelvis and hip area; superficial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82482","name":"Assay rbc cholinesterase","description":"Cholinesterase; rbc","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"94400","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L6970","name":"Interscapular-thor switch ct","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77285","name":"Ther rad simulaj field intrm","description":"Therapeutic radiology simulation-aided field setting; intermediate","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"E8002","name":"Anterior gait trainer","description":"Gait trainer, pediatric size, anterior support, includes all accessories and components","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1269.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94621","name":"Cardiopulm exercise testing","description":"Cardiopulmonary exercise testing, including measurements of minute ventilation, co2 production, o2 uptake, and electrocardiographic recordings","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0462","name":"Tlso 3mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the","date_of_service":"2026-05-10","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":"95827","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54550","name":"Exploration for testis","description":"Exploration for undescended testis (inguinal or scrotal area)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":616.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59414","name":"Deliver placenta","description":"Delivery of placenta (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"21084","name":"Impres&prep sp aid prosth","description":"Impression and custom preparation; speech aid prosthesis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1006.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87496","name":"Cytomeg dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); cytomegalovirus, amplified probe technique","date_of_service":"2026-05-10","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":"20553","name":"Njx 1/mlt trigger points 3/>","description":"Injection(s); single or multiple trigger point(s), 3 or more muscles","date_of_service":"2026-05-10","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":"27400","name":"Revise thigh muscles/tendons","description":"Transfer, tendon or muscle, hamstrings to femur (eg, eggers type procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":798.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"51565","name":"Revise bladder & ureter(s)","description":"Cystectomy, partial, with reimplantation of ureter(s) into bladder (ureteroneocystostomy)","date_of_service":"2026-05-10","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":"23660","name":"Optx acute shoulder dislc","description":"Open treatment of acute shoulder dislocation","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"79200","name":"Nuclear rx intracav admin","description":"Radiopharmaceutical therapy, by intracavitary administration","date_of_service":"2026-05-10","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":"55720","name":"Drainage of prostate abscess","description":"Prostatotomy, external drainage of prostatic abscess, any approach; simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3927","name":"Fo pip dip no jt spr pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"22865","name":"Rmvl tot arthrp 1ntrspc lmbr","description":"Removal of total disc arthroplasty (artificial disc), anterior approach, single interspace; lumbar","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"93505","name":"Endomyocardial biopsy","description":"Endomyocardial biopsy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73060","name":"X-ray exam of humerus","description":"Radiologic examination; humerus, minimum of 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"84432","name":"Assay of thyroglobulin","description":"Thyroglobulin","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"01150","name":"Anes rad px tumor of pelvis","description":"Anesthesia for radical procedures for tumor of pelvis, except hindquarter amputation","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"0297T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64864","name":"Repair of facial nerve","description":"Suture of facial nerve; extracranial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1011.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73580","name":"Contrast x-ray of knee joint","description":"Radiologic examination, knee, arthrography, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"28400","name":"Cltx calcaneal fx w/o mnpj","description":"Closed treatment of calcaneal fracture; without manipulation","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82776","name":"Galactose transferase test","description":"Galactose-1-phosphate uridyl transferase; screen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1295","name":"Wheelchair heavy duty fixed","description":"Heavy duty wheelchair, fixed full length arms, elevating legrest","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28600","name":"Treat foot dislocation","description":"Closed treatment of tarsometatarsal joint dislocation; without anesthesia","date_of_service":"2026-05-10","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":"L6925","name":"Wrist disart myoelectronic c","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-10","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":"E0779","name":"Amb infusion pump mechanical","description":"Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5087.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43313","name":"Esophagoplasty congenital","description":"Esophagoplasty for congenital defect (plastic repair or reconstruction), thoracic approach; without repair of congenital tracheoesophageal fistula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"37203","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67228","name":"Treatment x10sv retinopathy","description":"Treatment of extensive or progressive retinopathy (eg, diabetic retinopathy), photocoagulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"77305","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"G0344","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21249","name":"Reconstruction of jaw","description":"Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); complete","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1117.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23075","name":"Exc shoulder les sc < 3 cm","description":"Excision, tumor, soft tissue of shoulder area, subcutaneous; less than 3 cm","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28035","name":"Decompression of tibia nerve","description":"Release, tarsal tunnel (posterior tibial nerve decompression)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1336.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25392","name":"Shorten radius & ulna","description":"Osteoplasty, radius and ulna; shortening (excluding 64876)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1466.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93303","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; complete","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2410.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15952","name":"Exc trchntr pr ulc flp clsr","description":"Excision, trochanteric pressure ulcer, with skin flap closure;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62010","name":"Treatment of head injury","description":"Elevation of depressed skull fracture; with repair of dura and/or debridement of brain","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":948.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"86602","name":"Antinomyces antibody","description":"Antibody; actinomyces","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"72090","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1036","name":"Patient transfer system >300","description":"Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"20612","name":"Aspirate/inj ganglion cyst","description":"Aspiration and/or injection of ganglion cyst(s) any location","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-10","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":"78264","name":"Gastric emptying img study","description":"Gastric emptying imaging study (eg, solid, liquid, or both);","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q4077","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6210","name":"Foam drg >16<=48 sq in w/o b","description":"Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"54110","name":"Treatment of penis lesion","description":"Excision of penile plaque (peyronie disease);","date_of_service":"2026-05-10","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":"82787","name":"Igg 1 2 3 or 4 each","description":"Gammaglobulin (immunoglobulin); immunoglobulin subclasses (eg, igg1, 2, 3, or 4), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"75605","name":"Contrast exam thoracic aorta","description":"Aortography, thoracic, by serialography, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7120","name":"Ringers lactate infusion","description":"Ringers lactate infusion, up to 1000 cc","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"82044","name":"Ur albumin semiquantitative","description":"Albumin; urine (eg, microalbumin), semiquantitative (eg, reagent strip assay)","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"G6017","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1086.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0495","name":"Charger elec/combo vad, rep","description":"Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","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":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"31552","name":"Laryngoplasty laryngeal sten","description":"Laryngoplasty; for laryngeal stenosis, with graft, without indwelling stent placement, age 12 years or older","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95816","name":"Eeg awake and drowsy","description":"Electroencephalogram (eeg); including recording awake and drowsy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"56631","name":"Vlvctmy rad prtl uni lymphad","description":"Vulvectomy, radical, partial; with unilateral inguinofemoral lymphadenectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":735.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44381","name":"Small bowel endoscopy br/wa","description":"Ileoscopy, through stoma; with transendoscopic balloon dilation","date_of_service":"2026-05-10","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":"V2306","name":"Lens sphcyl trifocal 4.00/>6","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":871.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1600","name":"Ho flex frejka w/cov pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74261","name":"Ct colonography dx","description":"Computed tomographic (ct) colonography, diagnostic, including image postprocessing; without contrast material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92542","name":"Positional nystagmus test","description":"Positional nystagmus test, minimum of 4 positions, with recording","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66990","name":"Ophthalmic endoscope add-on","description":"Use of ophthalmic endoscope (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2030","name":"Kafo dbl solid stirrup w/o j","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar ak orthosis), without knee joint, custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82575","name":"Creatinine clearance test","description":"Creatinine; clearance","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"L0160","name":"Cerv sr wire occ/man pre ots","description":"Cervical, semi-rigid, wire frame occipital/mandibular support, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1583.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76120","name":"Cine/video x-rays","description":"Cineradiography/videoradiography, except where specifically included","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-10","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":"28222","name":"Release of foot tendons","description":"Tenolysis, flexor, foot; multiple tendons","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3031","name":"Foot lamin/prepreg composite","description":"Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1302.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90732","name":"Ppsv23 vacc 2 yrs+ subq/im","description":"Pneumococcal polysaccharide vaccine, 23-valent (ppsv23), adult or immunosuppressed patient dosage, when administered to individuals 2 years or older, for subcutaneous or intramuscular use","date_of_service":"2026-05-10","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":133.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32997","name":"Total lung lavage","description":"Total lung lavage (unilateral)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"J7504","name":"Lymphocyte immune globulin","description":"Lymphocyte immune globulin, antithymocyte globulin, equine, parenteral, 250 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"00214","name":"Anes icr px burr holes","description":"Anesthesia for intracranial procedures; burr holes, including ventriculography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57410","name":"Pelvic examination","description":"Pelvic examination under anesthesia (other than local)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96119","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":752.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55859","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":840.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54235","name":"Njx corpora cavernosa rx agt","description":"Injection of corpora cavernosa with pharmacologic agent(s) (eg, papaverine, phentolamine)","date_of_service":"2026-05-10","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":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"1125F","name":"Amnt pain noted pain prsnt","description":"Pain severity quantified; pain present (coa) (onc)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"31614","name":"Tracheostoma revj complex","description":"Tracheostoma revision; complex, with flap rotation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":745.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.64,"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":"53000","name":"Incision of urethra","description":"Urethrotomy or urethrostomy, external (separate procedure); pendulous urethra","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":941.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":"82664","name":"Electrophoretic test","description":"Electrophoretic technique, not elsewhere specified","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"75650","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25931","name":"Amputation follow-up surgery","description":"Transmetacarpal amputation; re-amputation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"86301","name":"Immunoassay tumor ca 19-9","description":"Immunoassay for tumor antigen, quantitative; ca 19-9","date_of_service":"2026-05-10","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":"J1100","name":"Dexamethasone sodium phos","description":"Injection, dexamethasone sodium phosphate, 1 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89136","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6445","name":"Conform band s w <3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75993","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"35510","name":"Art byp grft carotid-brchial","description":"Bypass graft, with vein; carotid-brachial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3964","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95052","name":"Photo patch tests","description":"Photo patch test(s) (specify number of tests)","date_of_service":"2026-05-10","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":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4361","name":"Pneuma/vac walk boot pre ots","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"64704","name":"Revise hand/foot nerve","description":"Neuroplasty; nerve of hand or foot","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"78071","name":"Parathyrd planar w/wo subtrj","description":"Parathyroid planar imaging (including subtraction, when performed); with tomographic (spect)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["26"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":528.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95990","name":"Spin/brain pump refil & main","description":"Refilling and maintenance of implantable pump or reservoir for drug delivery, spinal (intrathecal, epidural) or brain (intraventricular), includes electronic analysis of pump, when performed;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1089.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"77066","name":"Dx mammo incl cad bi","description":"Diagnostic mammography, including computer-aided detection (cad) when performed; bilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45327","name":"Proctosigmoidoscopy w/stent","description":"Proctosigmoidoscopy, rigid; with transendoscopic stent placement (includes predilation)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37718","name":"Lig div&strpg short saph vn","description":"Ligation, division, and stripping, short saphenous vein","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"25670","name":"Optx rdcrpl/ntrcrpl dislc 1+","description":"Open treatment of radiocarpal or intercarpal dislocation, 1 or more bones","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75952","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"28302","name":"Incision of ankle bone","description":"Osteotomy; talus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"16015","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"33305","name":"Repair of heart wound","description":"Repair of cardiac wound; with cardiopulmonary bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1576.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"15361","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61345","name":"Oth cranial dcmprn pst fossa","description":"Other cranial decompression, posterior fossa","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","date_of_service":"2026-05-10","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":"ATP18","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82101","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":337.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":625.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6884","name":"Replc sockt above elbow disa","description":"Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66155","name":"Glaucoma surgery","description":"Fistulization of sclera for glaucoma; thermocauterization with iridectomy","date_of_service":"2026-05-10","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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"83891","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"44133","name":"Enterectomy live donor","description":"Donor enterectomy (including cold preservation), open; partial, from living donor","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0627","name":"Lo sag ri an/pos pnl pre cst","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"Q4098","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"27640","name":"Partial removal of tibia","description":"Partial excision (craterization, saucerization, or diaphysectomy), bone (eg, osteomyelitis); tibia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":695.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"30435","name":"Revision of nose","description":"Rhinoplasty, secondary; intermediate revision (bony work with osteotomies)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1478.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43631","name":"Removal of stomach partial","description":"Gastrectomy, partial, distal; with gastroduodenostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46746","name":"Repair of cloacal anomaly","description":"Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, combined abdominal and sacroperineal approach;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83893","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"27781","name":"Treatment of fibula fracture","description":"Closed treatment of proximal fibula or shaft fracture; with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26479","name":"Shortening of hand tendon","description":"Shortening of tendon, flexor, hand or finger, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":846.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","date_of_service":"2026-05-10","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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1805","name":"Adjust wrist ext & flex dev","description":"Dynamic adjustable wrist extension and flexion device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99274","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":974.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1227.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20206","name":"Biopsy muscle perq needle","description":"Biopsy, muscle, percutaneous needle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"93618","name":"Indctj arrhythmia elec pacg","description":"Induction of arrhythmia by electrical pacing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"35481","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45390","name":"Colonoscopy w/resection","description":"Colonoscopy, flexible; with endoscopic mucosal resection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75956","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37187","name":"Venous mech thrombectomy","description":"Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","date_of_service":"2026-05-10","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":"83986","name":"Assay ph body fluid nos","description":"Ph; body fluid, not otherwise specified","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4020","name":"Cast sup lng arm splnt ped f","description":"Cast supplies, long arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-05-10","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":"11740","name":"Evacuation subungual hmtma","description":"Evacuation of subungual hematoma","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"66710","name":"Ciliary transsleral therapy","description":"Ciliary body destruction; cyclophotocoagulation, transscleral","date_of_service":"2026-05-10","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":"0197T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47505","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":616.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74305","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1005.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2670","name":"Totazoline hcl injection","description":"Injection, tolazoline hcl, up to 25 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1000.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"44680","name":"Surgical revision intestine","description":"Intestinal plication (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":878.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6251","name":"Absorpt drg <=16 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"24006","name":"Arthrt elbw capsl exc rls","description":"Arthrotomy of the elbow, with capsular excision for capsular release (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":845.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42971","name":"Control nose/throat bleeding","description":"Control of nasopharyngeal hemorrhage, primary or secondary (eg, postadenoidectomy); complicated, requiring hospitalization","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6900","name":"Hand restorat thumb/1 finger","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44405","name":"Colonoscopy w/dilation","description":"Colonoscopy through stoma; with transendoscopic balloon dilation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2510","name":"Th/wght bear quad-lat brim m","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"V2307","name":"Lens sphcy trifocal 4.25-7/.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28400","name":"Cltx calcaneal fx w/o mnpj","description":"Closed treatment of calcaneal fracture; without manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46261","name":"Remove in/ex hem grps & fiss","description":"Hemorrhoidectomy, internal and external, 2 or more columns/groups; with fissurectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62319","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77280","name":"Ther rad simulaj field smpl","description":"Therapeutic radiology simulation-aided field setting; simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J9065","name":"Inj cladribine per 1 mg","description":"Injection, cladribine, per 1 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59410","name":"Obstetrical care","description":"Vaginal delivery only (with or without episiotomy and/or forceps); including postpartum care","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"77409","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01961","name":"Anes cesarean delivery only","description":"Anesthesia for cesarean delivery only","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82382","name":"Assay urine catecholamines","description":"Catecholamines; total urine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4013","name":"Cast sup gauntlet plaster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29280","name":"Strapping of hand or finger","description":"Strapping; hand or finger","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1685","name":"Post-op hip abduct custom fa","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21337","name":"Closed tx septal&nose fx","description":"Closed treatment of nasal septal fracture, with or without stabilization","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95912","name":"Nrv cndj test 11-12 studies","description":"Nerve conduction studies; 11-12 studies","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"21275","name":"Revision orbitofacial bones","description":"Secondary revision of orbitocraniofacial reconstruction","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","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":"85547","name":"Rbc mechanical fragility","description":"Mechanical fragility, rbc","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"J0515","name":"Inj benztropine mesylate","description":"Injection, benztropine mesylate, per 1 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37607","name":"Lig/banding angioacs av fstl","description":"Ligation or banding of angioaccess arteriovenous fistula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":474.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"J0456","name":"Azithromycin","description":"Injection, azithromycin, 500 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0399","name":"Home sleep test/type 3 porta","description":"Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation","date_of_service":"2026-05-10","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":"88344","name":"Imhchem/imcytchm ea mlt antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0502","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93880","name":"Extracranial bilat study","description":"Duplex scan of extracranial arteries; complete bilateral study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1280","name":"Whchr h-duty det arm leg res","description":"Heavy duty wheelchair, detachable arms (desk or full length) elevating legrests","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2213","name":"Lens sphcyl bifo 7.25-12/4.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2070","name":"Hkafo torsion unilat rot str","description":"Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-05-10","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":"78290","name":"Intestine imaging","description":"Intestine imaging (eg, ectopic gastric mucosa, meckels localization, volvulus)","date_of_service":"2026-05-10","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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"27730","name":"Repair of tibia epiphysis","description":"Arrest, epiphyseal (epiphysiodesis), open; distal tibia","date_of_service":"2026-05-10","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":"97028","name":"Ultraviolet therapy","description":"Application of a modality to 1 or more areas; ultraviolet","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"95816","name":"Eeg awake and drowsy","description":"Electroencephalogram (eeg); including recording awake and drowsy","date_of_service":"2026-05-10","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":"00216","name":"Anes icr px vascular px","description":"Anesthesia for intracranial procedures; vascular procedures","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25365","name":"Revise radius & ulna","description":"Osteotomy; radius and ulna","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1391.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1054.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"J1020","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"00702","name":"Anes upr ant abd wall lvr bx","description":"Anesthesia for procedures on upper anterior abdominal wall; percutaneous liver biopsy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4430","name":"Ost urine pch w b/bltin conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"43772","name":"Lap rmvl gastr adj device","description":"Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable gastric restrictive device component only","date_of_service":"2026-05-10","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":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"17360","name":"Chemical exfoliation acne","description":"Chemical exfoliation for acne (eg, acne paste, acid)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"43255","name":"Egd control bleeding any","description":"Esophagogastroduodenoscopy, flexible, transoral; with control of bleeding, any method","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"67110","name":"Repair detached retina","description":"Repair of retinal detachment; by injection of air or other gas (eg, pneumatic retinopexy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KC"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36415","name":"Coll venous bld venipuncture","description":"Collection of venous blood by venipuncture","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"31368","name":"Partial removal of larynx","description":"Laryngectomy; subtotal supraglottic, with radical neck dissection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1822.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78588","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3260","name":"Ambulatory surgical boot eac","description":"Surgical boot/shoe, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"63251","name":"Revise spinal cord vsls thrc","description":"Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracic","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"33722","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1892.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":870.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72052","name":"X-ray exam neck spine 6/>vws","description":"Radiologic examination, spine, cervical; 6 or more views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97762","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95864","name":"Needle emg 4 extremities","description":"Needle electromyography; 4 extremities with or without related paraspinal areas","date_of_service":"2026-05-10","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":"Q4019","name":"Cast sup lng arm splnt ped p","description":"Cast supplies, long arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"99443","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35256","name":"Repair blvsl vn grf lxtr","description":"Repair blood vessel with vein graft; lower extremity","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1312.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6532","name":"Compress stking bk40-50 surg","description":"Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["AW"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2113.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":467.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"87276","name":"Influenza a ag if","description":"Infectious agent antigen detection by immunofluorescent technique; influenza a virus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84590","name":"Assay of vitamin a","description":"Vitamin a","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"24605","name":"Tx clsd elbow dislc req anes","description":"Treatment of closed elbow dislocation; requiring anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"14300","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":990.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83887","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"30210","name":"Nasal sinus therapy","description":"Displacement therapy (proetz type)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0974","name":"Tlso full corset","description":"Tlso, full corset","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"49250","name":"Excision of umbilicus","description":"Umbilectomy, omphalectomy, excision of umbilicus (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1848","name":"Ko dbl upright w/air pre ots","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6920","name":"Wrist disarticul switch ctrl","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4510","name":"Full length surg stocking","description":"Surgical stockings full length, each","date_of_service":"2026-05-10","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":"27658","name":"Repair of leg tendon each","description":"Repair, flexor tendon, leg; primary, without graft, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43634","name":"Removal of stomach partial","description":"Gastrectomy, partial, distal; with formation of intestinal pouch","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1788.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75962","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85415","name":"Fibrinolytic plasminogen","description":"Fibrinolytic factors and inhibitors; plasminogen activator","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78456","name":"Acute venous thrombus image","description":"Acute venous thrombosis imaging, peptide","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"87106","name":"Fungi identification yeast","description":"Culture, fungi, definitive identification, each organism; yeast","date_of_service":"2026-05-10","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":"73620","name":"X-ray exam of foot","description":"Radiologic examination, foot; 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33220","name":"Repair lead pace-defib dual","description":"Repair of 2 transvenous electrodes for permanent pacemaker or implantable defibrillator","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75872","name":"Vein x-ray skull epidural","description":"Venography, epidural, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64405","name":"Njx aa&/strd gr ocpl nrv","description":"Injection(s), anesthetic agent(s) and/or steroid; greater occipital nerve","date_of_service":"2026-05-10","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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1193.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56501","name":"Destroy vulva lesions sim","description":"Destruction of lesion(s), vulva; simple (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"37619","name":"Ligation of inf vena cava","description":"Ligation of inferior vena cava","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64907","name":"Nerve pedicle transfer","description":"Nerve pedicle transfer; second stage","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7639","name":"Dornase alfa non-comp unit","description":"Dornase alfa, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2270","name":"Varus/valgus strap padded/li","description":"Addition to lower extremity, varus/valgus correction (t) strap, padded/lined or malleolus pad","date_of_service":"2026-05-10","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":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82928","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95909","name":"Nrv cndj tst 5-6 studies","description":"Nerve conduction studies; 5-6 studies","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["TC"]}],"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":"2026-05-10","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":"00580","name":"Anes heart/lung transplant","description":"Anesthesia for heart transplant or heart/lung transplant","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":476.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1267.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87660","name":"Trichomonas vagin dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); trichomonas vaginalis, direct probe technique","date_of_service":"2026-05-10","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":"74328","name":"X-ray bile duct endoscopy","description":"Endoscopic catheterization of the biliary ductal system, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78630","name":"Cerebrospinal fluid scan","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74450","name":"X-ray urethra/bladder","description":"Urethrocystography, retrograde, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26541","name":"Repair hand joint with graft","description":"Reconstruction, collateral ligament, metacarpophalangeal joint, single; with tendon or fascial graft (includes obtaining graft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","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":"50065","name":"Nl sec surg operj calculus","description":"Nephrolithotomy; secondary surgical operation for calculus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43520","name":"Incision of pyloric muscle","description":"Pyloromyotomy, cutting of pyloric muscle (fredet-ramstedt type operation)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1482.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L0649","name":"Lso sc r pos/lat pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KC"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":526.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["26"]}],"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":"2026-05-10","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":"01260","name":"Anes all px veins upper leg","description":"Anesthesia for all procedures involving veins of upper leg, including exploration","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1447.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1023.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU","","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":506.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69802","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E0463","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53600","name":"Dilate urethra stricture","description":"Dilation of urethral stricture by passage of sound or urethral dilator, male; initial","date_of_service":"2026-05-10","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":"25695","name":"Optx lunate dislocation","description":"Open treatment of lunate dislocation","date_of_service":"2026-05-10","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":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46288","name":"Repair anal fistula","description":"Closure of anal fistula with rectal advancement flap","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"84132","name":"Assay of serum potassium","description":"Potassium; serum, plasma or whole blood","date_of_service":"2026-05-10","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":"33243","name":"Remove eltrd/thoracotomy","description":"Removal of single or dual chamber implantable defibrillator electrode(s); by thoracotomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1600.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"83050","name":"Hgb methemoglobin quan","description":"Hemoglobin; methemoglobin, quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87188","name":"Sc std macrobroth dil meth","description":"Susceptibility studies, antimicrobial agent; macrobroth dilution method, each agent","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-05-10","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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26568","name":"Lengthen metacarpal/finger","description":"Osteoplasty, lengthening, metacarpal or phalanx","date_of_service":"2026-05-10","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":"99354","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92502","name":"Ear and throat examination","description":"Otolaryngologic examination under general anesthesia","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":745.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40810","name":"Excision of mouth lesion","description":"Excision of lesion of mucosa and submucosa, vestibule of mouth; without repair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32606","name":"Thoracoscopy w/bx med space","description":"Thoracoscopy, diagnostic (separate procedure); mediastinal space, with biopsy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":"28345","name":"Repair webbed toe(s)","description":"Reconstruction, toe(s); syndactyly, with or without skin graft(s), each web","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q4098","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4678.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1221.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2700","name":"Oxacillin sodium injeciton","description":"Injection, oxacillin sodium, up to 250 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"77280","name":"Ther rad simulaj field smpl","description":"Therapeutic radiology simulation-aided field setting; simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":553.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5510","name":"Prep bk ptb plaster molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"94669","name":"Mechanical chest wall oscill","description":"Mechanical chest wall oscillation to facilitate lung function, per session","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"86403","name":"Particle agglut antbdy scrn","description":"Particle agglutination; screen, each antibody","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01130","name":"Anes body cast appl/revj","description":"Anesthesia for body cast application or revision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"92265","name":"Ndl oculoelectromyography 1+","description":"Needle oculoelectromyography, 1 or more extraocular muscles, 1 or both eyes, with interpretation and report","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43350","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":268.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0484","name":"Monitor elec or comb vad rep","description":"Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":559.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78700","name":"Kidney imaging morphol","description":"Kidney imaging morphology;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":883.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78306","name":"Bone imaging whole body","description":"Bone and/or joint imaging; whole body","date_of_service":"2026-05-10","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":"58280","name":"Hysterectomy/revise vagina","description":"Vaginal hysterectomy, with total or partial vaginectomy; with repair of enterocele","date_of_service":"2026-05-10","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":"93618","name":"Indctj arrhythmia elec pacg","description":"Induction of arrhythmia by electrical pacing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26455","name":"Incision of finger tendon","description":"Tenotomy, flexor, finger, open, each tendon","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":610.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62100","name":"Repair brain fluid leakage","description":"Craniotomy for repair of dural/cerebrospinal fluid leak, including surgery for rhinorrhea/otorrhea","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58541","name":"Lsh uterus 250 g or less","description":"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":464.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88160","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; screening and interpretation","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"71015","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"75831","name":"Vein x-ray kidney","description":"Venography, renal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"E0606","name":"Drainage board postural","description":"Postural drainage board","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93315","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report","date_of_service":"2026-05-10","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":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74177","name":"Ct abd & pelvis w/contrast","description":"Computed tomography, abdomen and pelvis; with contrast material(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27275","name":"Manipulation of hip joint","description":"Manipulation, hip joint, requiring general anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":937.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60252","name":"Removal of thyroid","description":"Thyroidectomy, total or subtotal for malignancy; with limited neck dissection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85044","name":"Manual reticulocyte count","description":"Blood count; reticulocyte, manual","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","date_of_service":"2026-05-10","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":"36821","name":"Av fusion direct any site","description":"Arteriovenous anastomosis, open; direct, any site (eg, cimino type) (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":663.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"92235","name":"Fluorescein angrph mltiframe","description":"Fluorescein angiography (includes multiframe imaging) with interpretation and report, unilateral or bilateral","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1147.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74415","name":"Urography nfs drip&/bls w/nf","description":"Urography, infusion, drip technique and/or bolus technique; with nephrotomography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1489.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"43231","name":"Esophagoscop ultrasound exam","description":"Esophagoscopy, flexible, transoral; with endoscopic ultrasound examination","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":518.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":528.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28232","name":"Incision of toe tendon","description":"Tenotomy, open, tendon flexor; toe, single tendon (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","date_of_service":"2026-05-10","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":"63702","name":"Repair of spinal herniation","description":"Repair of meningocele; larger than 5 cm diameter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1547.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"78135","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","date_of_service":"2026-05-10","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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"0356T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"78305","name":"Bone imaging multiple areas","description":"Bone and/or joint imaging; multiple areas","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"15365","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"27430","name":"Revision of thigh muscles","description":"Quadricepsplasty (eg, bennett or thompson type)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":884.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0486","name":"Tlso rigidlined cust fab two","description":"Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlappin","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32525","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1928.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90734","name":"Menacwyd/menacwycrm vacc im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, diphtheria toxoid carrier (menacwy-d) or crm197 carrier (menacwy-crm), for intramuscular use","date_of_service":"2026-05-10","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":201.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61524","name":"Removal of brain lesion","description":"Craniectomy, infratentorial or posterior fossa; for excision or fenestration of cyst","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2319.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1832","name":"Ko adj jnt pos r sup pre cst","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2000.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20550","name":"Njx 1 tendon sheath/ligament","description":"Injection(s); single tendon sheath, or ligament, aponeurosis (eg, plantar fascia)","date_of_service":"2026-05-10","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":"33670","name":"Repair of heart chambers","description":"Repair of complete atrioventricular canal, with or without prosthetic valve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1406","name":"O2/water vapor enrich w/o he","description":"Oxygen and water vapor enriching system without heated delivery","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"G0461","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"L5500","name":"Init bk ptb plaster direct","description":"Initial, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":637.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32557","name":"Insert cath pleura w/ image","description":"Pleural drainage, percutaneous, with insertion of indwelling catheter; with imaging guidance","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1391.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6229","name":"Gauze >16<=48 sq in watr/sal","description":"Gauze, impregnated, water or normal saline, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"39520","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1611.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":570.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-10","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":"32662","name":"Thoracoscopy w/mediast exc","description":"Thoracoscopy, surgical; with excision of mediastinal cyst, tumor, or mass","date_of_service":"2026-05-10","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":"51726","name":"Complex cystometrogram","description":"Complex cystometrogram (ie, calibrated electronic equipment);","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"43211","name":"Esophagoscop mucosal resect","description":"Esophagoscopy, flexible, transoral; with endoscopic mucosal resection","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"88362","name":"Nerve teasing preparations","description":"Nerve teasing preparations","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"74241","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50010","name":"Renal exploration","description":"Renal exploration, not necessitating other specific procedures","date_of_service":"2026-05-10","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":"L3215","name":"Orthopedic ftwear ladies oxf","description":"Orthopedic footwear, ladies shoe, oxford, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"1160F","name":"Rvw meds by rx/dr in rcrd","description":"Review of all medications by a prescribing practitioner or clinical pharmacist (such as, prescriptions, otcs, herbal therapies and supplements) documented in the medical record (coa)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":604.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84436","name":"Assay of total thyroxine","description":"Thyroxine; total","date_of_service":"2026-05-10","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":"21386","name":"Opn tx orbit fx periorbital","description":"Open treatment of orbital floor blowout fracture; periorbital approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23125","name":"Claviculectomy total","description":"Claviculectomy; total","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":847.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70220","name":"X-ray exam of sinuses","description":"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views","date_of_service":"2026-05-10","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":"72132","name":"Ct lumbar spine w/dye","description":"Computed tomography, lumbar spine; with contrast material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-10","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":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0948","name":"Fracture frame attachmnts ce","description":"Fracture frame, attachments for complex cervical traction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"45505","name":"Repair of rectum","description":"Proctoplasty; for prolapse of mucous membrane","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5857","name":"Elec knee-shin swing only","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4201.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62146","name":"Crnop w/autograft<5 cm diam","description":"Cranioplasty with autograft (includes obtaining bone grafts); up to 5 cm diameter","date_of_service":"2026-05-10","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":"33010","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3675","name":"So vest canvas/web pre ots","description":"Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00700","name":"Anes px upr ant abd wall nos","description":"Anesthesia for procedures on upper anterior abdominal wall; not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78812","name":"Pet image skull-thigh","description":"Positron emission tomography (pet) imaging; skull base to mid-thigh","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1208.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46900","name":"Destruction anal lesion(s)","description":"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; chemical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4390","name":"Drainable pch ex wear convex","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"J0704","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54550","name":"Exploration for testis","description":"Exploration for undescended testis (inguinal or scrotal area)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":657.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"29819","name":"Sho arthrs srg rmvl loose/fb","description":"Arthroscopy, shoulder, surgical; with removal of loose body or foreign body","date_of_service":"2026-05-10","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":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29584","name":"Appl mltlay cmprn sys up arm","description":"Application of multi-layer compression system; upper arm, forearm, hand, and fingers","date_of_service":"2026-05-10","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":"33244","name":"Remove elctrd transvenously","description":"Removal of single or dual chamber implantable defibrillator electrode(s); by transvenous extraction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92283","name":"Extnd color vision xm","description":"Color vision examination, extended, eg, anomaloscope or equivalent","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95857","name":"Cholinesterase challenge","description":"Cholinesterase inhibitor challenge test for myasthenia gravis","date_of_service":"2026-05-10","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":"E1227","name":"Wheelchair spec sz spec ht a","description":"Special height arms for wheelchair","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0941","name":"Gravity assisted traction de","description":"Gravity assisted traction device, any type","date_of_service":"2026-05-10","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":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-10","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":"57400","name":"Dilation of vagina","description":"Dilation of vagina under anesthesia (other than local)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"70552","name":"Mri brain stem w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s)","date_of_service":"2026-05-10","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":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5503","name":"Diabetic shoe w/roller/rockr","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78205","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68135","name":"Destruction les conjunctiva","description":"Destruction of lesion, conjunctiva","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","date_of_service":"2026-05-10","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":"L3214","name":"Benesch boot pair junior","description":"Benesch boot, pair, junior","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"44850","name":"Repair of mesentery","description":"Suture of mesentery (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33600","name":"Closure of valve","description":"Closure of atrioventricular valve (mitral or tricuspid) by suture or patch","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2080.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"15792","name":"Chem peel nonfacial epidrm","description":"Chemical peel, nonfacial; epidermal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42550","name":"Injection for salivary x-ray","description":"Injection procedure for sialography","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"72050","name":"X-ray exam neck spine 4/5vws","description":"Radiologic examination, spine, cervical; 4 or 5 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95829","name":"Surgery electrocorticogram","description":"Electrocorticogram at surgery (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86367","name":"Stem cells total count","description":"Stem cells (ie, cd34), total count","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":873.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"85048","name":"Automated leukocyte count","description":"Blood count; leukocyte (wbc), automated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"54125","name":"Removal of penis","description":"Amputation of penis; complete","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42950","name":"Reconstruction of throat","description":"Pharyngoplasty (plastic or reconstructive operation on pharynx)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":943.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42140","name":"Excision of uvula","description":"Uvulectomy, excision of uvula","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5230","name":"Fem focal defic constant fri","description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":928.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"78582","name":"Lung ventilat&perfus imaging","description":"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"80200","name":"Assay of tobramycin","description":"Tobramycin","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1165","name":"Phenytoin sodium injection","description":"Injection, phenytoin sodium, per 50 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93612","name":"Intraventricular pacing","description":"Intraventricular pacing","date_of_service":"2026-05-10","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":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6676","name":"Harness figure of 8 dual con","description":"Upper extremity addition, harness, (e.g., figure of eight type), dual cable design","date_of_service":"2026-05-10","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":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"31614","name":"Tracheostoma revj complex","description":"Tracheostoma revision; complex, with flap rotation","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"L1520","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35525","name":"Art byp grft brachial-brchl","description":"Bypass graft, with vein; brachial-brachial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"66930","name":"Extraction of lens","description":"Removal of lens material; intracapsular, for dislocated lens","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4613","name":"Battery charger","description":"Battery charger; replacement for patient-owned ventilator","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"26556","name":"Toe joint transfer","description":"Transfer, free toe joint, with microvascular anastomosis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"44188","name":"Lap colostomy","description":"Laparoscopy, surgical, colostomy or skin level cecostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4418","name":"Ost pch clsd w/o bar w filtr","description":"Ostomy pouch, closed; without barrier attached, with filter (1 piece), each","date_of_service":"2026-05-10","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":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1443.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1721.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"25676","name":"Optx rad/uln dislc aqt/chrnc","description":"Open treatment of distal radioulnar dislocation, acute or chronic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P2038","name":"Blood mucoprotein","description":"Mucoprotein, blood (seromucoid) (medical necessity procedure)","date_of_service":"2026-05-10","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":"L1680","name":"Pelvic & hip control thigh c","description":"Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"72072","name":"X-ray exam thorac spine 3vws","description":"Radiologic examination, spine; thoracic, 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67801","name":"Remove eyelid lesions","description":"Excision of chalazion; multiple, same lid","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01360","name":"Anes open px lower 1/3 femur","description":"Anesthesia for all open procedures on lower one-third of femur","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"99225","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-10","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":"28286","name":"Repair of hammertoe","description":"Correction, cock-up fifth toe, with plastic skin closure (eg, ruiz-mora type procedure)","date_of_service":"2026-05-10","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":"78805","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91120","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71111","name":"X-ray exam ribs/chest4/> vws","description":"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"80103","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0355T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19355","name":"Correct inverted nipple(s)","description":"Correction of inverted nipples","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":953.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0603","name":"Repl batt alkaline 1.5 v","description":"Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71250","name":"Ct thorax dx c-","description":"Computed tomography, thorax, diagnostic; without contrast material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95865","name":"Needle emg larynx","description":"Needle electromyography; larynx","date_of_service":"2026-05-10","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":"54163","name":"Repair of circumcision","description":"Repair incomplete circumcision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-05-10","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":"L0623","name":"Sio rig pnl pelv/sac pre ots","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29044","name":"Appl bdy cst sho to hip 1thi","description":"Application of body cast, shoulder to hips; including 1 thigh","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G0120","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"21465","name":"Optx mndblr cndylr fx","description":"Open treatment of mandibular condylar fracture","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1049.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1295","name":"Wheelchair heavy duty fixed","description":"Heavy duty wheelchair, fixed full length arms, elevating legrest","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26494","name":"Hand tendon/muscle transfer","description":"Opponensplasty; hypothenar muscle transfer","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27686","name":"Revise lower leg tendons","description":"Lengthening or shortening of tendon, leg or ankle; multiple tendons (through same incision), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":694.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"82554","name":"Creatine isoforms","description":"Creatine kinase (ck), (cpk); isoforms","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"66711","name":"Ecp ciliary body destruction","description":"Ciliary body destruction; cyclophotocoagulation, endoscopic, without concomitant removal of crystalline lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0217","name":"Water circ heat pad w pump","description":"Water circulating heat pad with pump","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP23","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"P9612","name":"Catheterize for urine spec","description":"Catheterization for collection of specimen, single patient, all places of service","date_of_service":"2026-05-10","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":"00600","name":"Anes px crv spine&cord nos","description":"Anesthesia for procedures on cervical spine and cord; not otherwise specified","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"31595","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1016.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q0176","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20245","name":"Bone biopsy open deep","description":"Biopsy, bone, open; deep (eg, humeral shaft, ischium, femoral shaft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"93278","name":"Ecg/signal-averaged","description":"Signal-averaged electrocardiography (saecg), with or without ecg","date_of_service":"2026-05-10","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":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"24110","name":"Exc/curtg b1 cst/b9 tum hum","description":"Excision or curettage of bone cyst or benign tumor, humerus;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35355","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; iliofemoral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86171","name":"Complement fixation each","description":"Complement fixation tests, each antigen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84134","name":"Assay of prealbumin","description":"Prealbumin","date_of_service":"2026-05-10","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":"87482","name":"Candida dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); candida species, quantification","date_of_service":"2026-05-10","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":"42106","name":"Excision lesion mouth roof","description":"Excision, lesion of palate, uvula; with simple primary closure","date_of_service":"2026-05-10","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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":884.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57820","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7506","name":"Hmes/trachvalve adhesivedisk","description":"Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42961","name":"Control throat bleeding","description":"Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); complicated, requiring hospitalization","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"V2106","name":"Spherocylinder 4.00d/>6.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30545","name":"Rpr choanal atresia trsnpltn","description":"Repair choanal atresia; transpalatine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1140.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86812","name":"Hla typing a b or c","description":"Hla typing; a, b, or c (eg, a10, b7, b27), single antigen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77786","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"90806","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"26641","name":"Treat thumb dislocation","description":"Closed treatment of carpometacarpal dislocation, thumb, with manipulation","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5782","name":"Hd low limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty","date_of_service":"2026-05-10","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":"92986","name":"Revision of aortic valve","description":"Percutaneous balloon valvuloplasty; aortic valve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1489.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"J1530","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"43870","name":"Closure gastrostomy surgical","description":"Closure of gastrostomy, surgical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"60260","name":"Repeat thyroid surgery","description":"Thyroidectomy, removal of all remaining thyroid tissue following previous removal of a portion of thyroid","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"49002","name":"Reopening of abdomen","description":"Reopening of recent laparotomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7505","name":"Hmes or trach valve housing","description":"Housing, reusable without adhesive, for use in a heat and moisture exchange system and/or with a tracheostoma valve, each","date_of_service":"2026-05-10","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":"25145","name":"Remove forearm bone lesion","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), forearm and/or wrist","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"48552","name":"Prep donor pancreas/venous","description":"Backbench reconstruction of cadaver donor pancreas allograft prior to transplantation, venous anastomosis, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3809","name":"Whfo w/o joints pre ots","description":"Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83491","name":"Asy hydroxycorticosteroids17","description":"Hydroxycorticosteroids, 17- (17-ohcs)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2610","name":"Hip clevis/thrust bearing lo","description":"Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82017","name":"Acylcarnitines quant","description":"Acylcarnitines; quantitative, each specimen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"46754","name":"Removal of suture from anus","description":"Removal of thiersch wire or suture, anal canal","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0621","name":"Sio flex pelvic/sacr pre ots","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":"38205","name":"Harvest allogeneic stem cell","description":"Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; allogeneic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"29131","name":"Appl finger splint dynamic","description":"Application of finger splint; dynamic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1011.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-10","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":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4372","name":"Skin barrier solid 4x4 equiv","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each","date_of_service":"2026-05-10","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":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","date_of_service":"2026-05-10","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":"27409","name":"Repair of knee ligaments","description":"Repair, primary, torn ligament and/or capsule, knee; collateral and cruciate ligaments","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22864","name":"Rmvl tot arthrp 1ntrspc crv","description":"Removal of total disc arthroplasty (artificial disc), anterior approach, single interspace; cervical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2037","name":"Kafo plas sing free knee mol","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31775","name":"Reconstruct bronchus","description":"Bronchoplasty; excision stenosis and anastomosis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1711.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"24575","name":"Optx humeral epcndylr fx","description":"Open treatment of humeral epicondylar fracture, medial or lateral, includes internal fixation, when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67904","name":"Repair eyelid defect","description":"Repair of blepharoptosis; (tarso) levator resection or advancement, external approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":529.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4427","name":"Ost pch drain/barr lk flng/f","description":"Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92520","name":"Laryngeal function studies","description":"Laryngeal function studies (ie, aerodynamic testing and acoustic testing)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"93925","name":"Lower extremity study","description":"Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5540","name":"Prep bk ptb laminated socket","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"92072","name":"Fitg c-lens keratoconus 1st","description":"Fitting of contact lens for management of keratoconus, initial fitting","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59430","name":"Care after delivery","description":"Postpartum care only (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90586","name":"Bcg vaccine intravesical","description":"Bacillus calmette-guerin vaccine (bcg) for bladder cancer, live, for intravesical use","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6233","name":"Hydrogel dressing >48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing","date_of_service":"2026-05-10","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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V5010","name":"Assessment for hearing aid","description":"Assessment for hearing aid","date_of_service":"2026-05-10","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":"66183","name":"Insert ant drainage device","description":"Insertion of anterior segment aqueous drainage device, without extraocular reservoir, external approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90819","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5513","name":"Multi den insert custom mold","description":"For diabetics only, multiple density insert, custom molded from model of patients foot, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15781","name":"Dermabrasion segmental face","description":"Dermabrasion; segmental, face","date_of_service":"2026-05-10","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":"72255","name":"Myelography thoracic spine","description":"Myelography, thoracic, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93539","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0398T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3105","name":"Terbutaline sulfate inj","description":"Injection, terbutaline sulfate, up to 1 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"93886","name":"Intracranial complete study","description":"Transcranial doppler study of the intracranial arteries; complete study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43760","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"95978","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"74291","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"83051","name":"Hemoglobin plasma","description":"Hemoglobin; plasma","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"54861","name":"Removal of epididymis","description":"Epididymectomy; bilateral","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A7509","name":"Heat & moisture exchange sys","description":"Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J0200","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2708.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2103","name":"Spherocylindr 4.00d/12-2.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2403.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28540","name":"Treat foot dislocation","description":"Closed treatment of tarsal bone dislocation, other than talotarsal; without anesthesia","date_of_service":"2026-05-10","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":"77403","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L6885","name":"Replc sockt shldr dis/interc","description":"Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1580.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78579","name":"Lung ventilation imaging","description":"Pulmonary ventilation imaging (eg, aerosol or gas)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"59025","name":"Fetal non-stress test","description":"Fetal non-stress test","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93544","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"E0740","name":"Non-implant pelv flr e-stim","description":"Non-implanted pelvic floor electrical stimulator, complete system","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":"82955","name":"Assay of g6pd enzyme","description":"Glucose-6-phosphate dehydrogenase (g6pd); quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61880","name":"Revise/remove neuroelectrode","description":"Revision or removal of intracranial neurostimulator electrodes","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27626","name":"Remove ankle joint lining","description":"Arthrotomy, with synovectomy, ankle; including tenosynovectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","date_of_service":"2026-05-10","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":"E1160","name":"Wheelchair fixed arms","description":"Wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"26040","name":"Release palm contracture","description":"Fasciotomy, palmar (eg, dupuytrens contracture); percutaneous","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78428","name":"Cardiac shunt imaging","description":"Cardiac shunt detection","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"23405","name":"Incision of tendon & muscle","description":"Tenotomy, shoulder area; single tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70170","name":"X-ray exam of tear duct","description":"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"J9035","name":"Bevacizumab injection","description":"Injection, bevacizumab, 10 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"28750","name":"Fusion of big toe joint","description":"Arthrodesis, great toe; metatarsophalangeal joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23650","name":"Cltx sho dslc w/mnpj wo anes","description":"Closed treatment of shoulder dislocation, with manipulation; without anesthesia","date_of_service":"2026-05-10","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":"86704","name":"Hep b core antibody total","description":"Hepatitis b core antibody (hbcab); total","date_of_service":"2026-05-10","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":"15360","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33802","name":"Division aberrant vessel","description":"Division of aberrant vessel (vascular ring);","date_of_service":"2026-05-10","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":"67120","name":"Remove eye implant material","description":"Removal of implanted material, posterior segment; extraocular","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"42335","name":"Removal of salivary stone","description":"Sialolithotomy; submandibular (submaxillary), complicated, intraoral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51925","name":"Hysterectomy/bladder repair","description":"Closure of vesicouterine fistula; with hysterectomy","date_of_service":"2026-05-10","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":"27238","name":"Treat thigh fracture","description":"Closed treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; without manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":526.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"27786","name":"Treatment of ankle fracture","description":"Closed treatment of distal fibular fracture (lateral malleolus); without manipulation","date_of_service":"2026-05-10","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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6255","name":"Absorpt drg >16<=48 in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-10","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":"L0430","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"21632","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1433.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"51736","name":"Urine flow measurement","description":"Simple uroflowmetry (ufr) (eg, stop-watch flow rate, mechanical uroflowmeter)","date_of_service":"2026-05-10","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":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","date_of_service":"2026-05-10","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":"61760","name":"Implant brain electrodes","description":"Stereotactic implantation of depth electrodes into the cerebrum for long-term seizure monitoring","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1654.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84550","name":"Assay of blood/uric acid","description":"Uric acid; blood","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"61312","name":"Crnec/crnot sttl xdrl/sdrl","description":"Craniectomy or craniotomy for evacuation of hematoma, supratentorial; extradural or subdural","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1902.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77013","name":"Ct guide for tissue ablation","description":"Computed tomography guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61624","name":"Tcat perm occls/embolj cns","description":"Transcatheter permanent occlusion or embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a vascular malformation), including all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention, percutaneous,","date_of_service":"2026-05-10","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":"85032","name":"Manual cell count each","description":"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each","date_of_service":"2026-05-10","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":"44320","name":"Colostomy","description":"Colostomy or skin level cecostomy;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1225.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0308","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15040","name":"Harvest cultured skin graft","description":"Harvest of skin for tissue cultured skin autograft, 100 sq cm or less","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26842","name":"Thumb fusion with graft","description":"Arthrodesis, carpometacarpal joint, thumb, with or without internal fixation; with autograft (includes obtaining graft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1061.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6629","name":"Lamination collar w/ couplin","description":"Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78231","name":"Salivary glnd img serial img","description":"Salivary gland imaging; with serial images","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0275T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-10","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":"74742","name":"X-ray fallopian tube","description":"Transcervical catheterization of fallopian tube, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"95861","name":"Needle emg 2 extremities","description":"Needle electromyography; 2 extremities with or without related paraspinal areas","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"84597","name":"Assay of vitamin k","description":"Vitamin k","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"86803","name":"Hepatitis c ab test","description":"Hepatitis c antibody;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"88362","name":"Nerve teasing preparations","description":"Nerve teasing preparations","date_of_service":"2026-05-10","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":"42260","name":"Repair nose to lip fistula","description":"Repair of nasolabial fistula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45395","name":"Lap removal of rectum","description":"Laparoscopy, surgical; proctectomy, complete, combined abdominoperineal, with colostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1572.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58970","name":"Retrieval of oocyte","description":"Follicle puncture for oocyte retrieval, any method","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5506","name":"Diabetic shoe w/off set heel","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"64740","name":"Incision of tongue nerve","description":"Transection or avulsion of; lingual nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A5512","name":"Multi den insert direct form","description":"For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patients foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","date_of_service":"2026-05-10","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":"51992","name":"Laparo sling operation","description":"Laparoscopy, surgical; sling operation for stress incontinence (eg, fascia or synthetic)","date_of_service":"2026-05-10","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":"52330","name":"Cystoscopy and treatment","description":"Cystourethroscopy (including ureteral catheterization); with manipulation, without removal of ureteral calculus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4413","name":"2 pc drainable ost pouch","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":510.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":"35501","name":"Art byp grft ipsilat carotid","description":"Bypass graft, with vein; common carotid-ipsilateral internal carotid","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"59514","name":"Cesarean delivery only","description":"Cesarean delivery only;","date_of_service":"2026-05-10","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":"A6237","name":"Hydrocolld drg <=16 in w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6247","name":"Hydrogel drg > 48 sq in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7928.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78645","name":"Csf shunt evaluation","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation","date_of_service":"2026-05-10","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":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","date_of_service":"2026-05-10","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":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"L5270","name":"Tilt table locking hip sing","description":"Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-10","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":"76102","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5679","name":"Socket insert w/o lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1307.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"39530","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0360","name":"Hydralazine hcl injection","description":"Injection, hydralazine hcl, up to 20 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33710","name":"Repair of heart defects","description":"Repair sinus of valsalva fistula, with cardiopulmonary bypass; with repair of ventricular septal defect","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2157.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0947","name":"Fracture frame attachmnts pe","description":"Fracture frame, attachments for complex pelvic traction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85345","name":"Coagulation time lee & white","description":"Coagulation time; lee and white","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L8690","name":"Aud osseo dev, int/ext comp","description":"Auditory osseointegrated device, includes all internal and external components","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q0170","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"78465","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6236","name":"Hydrocolld drg > 48 in w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51725","name":"Simple cystometrogram","description":"Simple cystometrogram (cmg) (eg, spinal manometer)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"82480","name":"Assay serum cholinesterase","description":"Cholinesterase; serum","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79101","name":"Nuclear rx iv admin","description":"Radiopharmaceutical therapy, by intravenous administration","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"26455","name":"Incision of finger tendon","description":"Tenotomy, flexor, finger, open, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83930","name":"Assay of blood osmolality","description":"Osmolality; blood","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72156","name":"Mri neck spine w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, spinal canal and contents, without contrast material, followed by contrast material(s) and further sequences; cervical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1434.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49002","name":"Reopening of abdomen","description":"Reopening of recent laparotomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":751.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"24100","name":"Arthrt elbw synovial bx only","description":"Arthrotomy, elbow; with synovial biopsy only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":467.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"80190","name":"Assay of procainamide","description":"Procainamide;","date_of_service":"2026-05-10","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":"L6695","name":"Elbow socket ins use w/o lck","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86750","name":"Malaria antibody","description":"Antibody; plasmodium (malaria)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35480","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21243","name":"Reconstruction of jaw joint","description":"Arthroplasty, temporomandibular joint, with prosthetic joint replacement","date_of_service":"2026-05-10","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":"28261","name":"Revision of foot tendon","description":"Capsulotomy, midfoot; with tendon lengthening","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1007.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51784","name":"Anal/urinary muscle study","description":"Electromyography studies (emg) of anal or urethral sphincter, other than needle, any technique","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"89160","name":"Exam feces for meat fibers","description":"Meat fibers, feces","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28360","name":"Reconstruct cleft foot","description":"Reconstruction, cleft foot","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92604","name":"Reprogram cochlear implt 7/>","description":"Diagnostic analysis of cochlear implant, age 7 years or older; subsequent reprogramming","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64486","name":"Tap block unil by injection","description":"Transversus abdominis plane (tap) block (abdominal plane block, rectus sheath block) unilateral; by injection(s) (includes imaging guidance, when performed)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"L1843","name":"Ko single upright pre cst","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"71021","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2509.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64734","name":"Incision of cheek nerve","description":"Transection or avulsion of; infraorbital nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1368.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":562.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"92560","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77031","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6224","name":"Gauze > 48 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","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":"33968","name":"Remove aortic assist device","description":"Removal of intra-aortic balloon assist device, percutaneous","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"23470","name":"Reconstruct shoulder joint","description":"Arthroplasty, glenohumeral joint; hemiarthroplasty","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1014.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0745","name":"Neuromuscular stim for shock","description":"Neuromuscular stimulator, electronic shock unit","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4356","name":"Ext ureth clmp or compr dvc","description":"External urethral clamp or compression device (not to be used for catheter clamp), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-05-10","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":"93230","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83001","name":"Assay of gonadotropin (fsh)","description":"Gonadotropin; follicle stimulating hormone (fsh)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77615","name":"Hyperthermia ntrstl prb>5","description":"Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26862","name":"Fusion/graft of finger joint","description":"Arthrodesis, interphalangeal joint, with or without internal fixation; with autograft (includes obtaining graft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":961.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"J7310","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4240.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93886","name":"Intracranial complete study","description":"Transcranial doppler study of the intracranial arteries; complete study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1138.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1008.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99337","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5501","name":"Diabetic custom molded shoe","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patients foot (custom molded shoe), per shoe","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","date_of_service":"2026-05-10","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":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","date_of_service":"2026-05-10","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":"64570","name":"Remove vagus n eltrd","description":"Removal of cranial nerve (eg, vagus nerve) neurostimulator electrode array and pulse generator","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"59866","name":"Abortion (mpr)","description":"Multifetal pregnancy reduction(s) (mpr)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"33542","name":"Removal of heart lesion","description":"Myocardial resection (eg, ventricular aneurysmectomy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2288.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"78701","name":"Kidney imaging with flow","description":"Kidney imaging morphology; with vascular flow","date_of_service":"2026-05-10","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":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L4396","name":"Static or dynami afo pre cst","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64517","name":"N block inj hypogas plxs","description":"Injection, anesthetic agent; superior hypogastric plexus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15953","name":"Exc trchntr pr ulc flp ostc","description":"Excision, trochanteric pressure ulcer, with skin flap closure; with ostectomy","date_of_service":"2026-05-10","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":"27487","name":"Revise/replace knee joint","description":"Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2100.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-10","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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"A6451","name":"Mod compres band w>=3in<5in/yd","description":"Moderate compression bandage, elastic, knitted/woven, load resistance of 1.25 to 1.34 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"83593","name":"Fractionation ketosteroids","description":"Ketosteroids, 17- (17-ks); fractionation","date_of_service":"2026-05-10","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":"27391","name":"Incision of thigh tendons","description":"Tenotomy, open, hamstring, knee to hip; multiple tendons, 1 leg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96152","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0482","name":"Tlso rigid lined custom fab","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50815","name":"Urine shunt to intestine","description":"Ureterocolon conduit, including intestine anastomosis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1312.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86717","name":"Leishmania antibody","description":"Antibody; leishmania","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","date_of_service":"2026-05-10","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":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4358","name":"Urinary leg or abdomen bag","description":"Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6945","name":"Elbow disart myoelectronic c","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5174.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"88108","name":"Cytopath concentrate tech","description":"Cytopathology, concentration technique, smears and interpretation (eg, saccomanno technique)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67825","name":"Revise eyelashes","description":"Correction of trichiasis; epilation by other than forceps (eg, by electrosurgery, cryotherapy, laser surgery)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58561","name":"Hysteroscopy remove myoma","description":"Hysteroscopy, surgical; with removal of leiomyomata","date_of_service":"2026-05-10","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":"E0779","name":"Amb infusion pump mechanical","description":"Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"E1810","name":"Adjust knee ext & flex dev","description":"Dynamic adjustable knee extension and flexion device, includes soft interface material","date_of_service":"2026-05-10","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":"L1600","name":"Ho flex frejka w/cov pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise","date_of_service":"2026-05-10","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":"26460","name":"Incise hand/finger tendon","description":"Tenotomy, extensor, hand or finger, open, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4313","name":"Catheter w/bag 3-way","description":"Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L0625","name":"Lo flex l1-below l5 pre ots","description":"Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83785","name":"Assay of manganese","description":"Manganese","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L3254","name":"Orth foot non-stndard size/w","description":"Non-standard size or width","date_of_service":"2026-05-10","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":"94662","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"97532","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"90808","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"55873","name":"Cryoablate prostate","description":"Cryosurgical ablation of the prostate (includes ultrasonic guidance and monitoring)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1302.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"90935","name":"Hemodialysis one evaluation","description":"Hemodialysis procedure with single evaluation by a physician or other qualified health care professional","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"51535","name":"Repair of ureter lesion","description":"Cystotomy for excision, incision, or repair of ureterocele","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27370","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"51784","name":"Anal/urinary muscle study","description":"Electromyography studies (emg) of anal or urethral sphincter, other than needle, any technique","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93880","name":"Extracranial bilat study","description":"Duplex scan of extracranial arteries; complete bilateral study","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"J2780","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-10","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":"E1270","name":"Wheelchair lightweight leg r","description":"Lightweight wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22505","name":"Manipulation of spine","description":"Manipulation of spine requiring anesthesia, any region","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4064.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","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":"84126","name":"Assay of feces porphyrins","description":"Porphyrins, feces, quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"00160","name":"Anes px nose&sinus nos","description":"Anesthesia for procedures on nose and accessory sinuses; not otherwise specified","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"Q0487","name":"Leads any type vad, rep only","description":"Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"84285","name":"Assay of silica","description":"Silica","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"21315","name":"Clsd tx nsl fx mnpj wo stblj","description":"Closed treatment of nasal bone fracture with manipulation; without stabilization","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"70380","name":"X-ray exam of salivary gland","description":"Radiologic examination, salivary gland for calculus","date_of_service":"2026-05-10","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":"54401","name":"Insert self-contd prosthesis","description":"Insertion of penile prosthesis; inflatable (self-contained)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":532.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","date_of_service":"2026-05-10","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":"L3931","name":"Whfo nontorsion joint prefab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01965","name":"Anes incompl/missed ab px","description":"Anesthesia for incomplete or missed abortion procedures","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"31717","name":"Bronchial brush biopsy","description":"Catheterization with bronchial brush biopsy","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A5057","name":"1 pc ost pou w built-in conv","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"16036","name":"Escharotomy ea addl incision","description":"Escharotomy; each additional incision (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"B9000","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36481","name":"Insertion of catheter vein","description":"Percutaneous portal vein catheterization by any method","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"70350","name":"X-ray head for orthodontia","description":"Cephalogram, orthodontic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-10","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":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","date_of_service":"2026-05-10","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":"46754","name":"Removal of suture from anus","description":"Removal of thiersch wire or suture, anal canal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":862.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80100","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0493","name":"Emr pwr cbl combo vad, rep","description":"Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84307","name":"Assay of somatostatin","description":"Somatostatin","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"86341","name":"Islet cell antibody","description":"Islet cell antibody","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L2114","name":"Afo tib fx semi-rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2836.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91030","name":"Acid perfusion of esophagus","description":"Esophagus, acid perfusion (bernstein) test for esophagitis","date_of_service":"2026-05-10","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":"L3670","name":"So acro/clav can web pre ots","description":"Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-10","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":"77615","name":"Hyperthermia ntrstl prb>5","description":"Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23035","name":"Incision bone cortex sho","description":"Incision, bone cortex (eg, osteomyelitis or bone abscess), shoulder area","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2185.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"L2415","name":"Knee joint cam lock each joi","description":"Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":981.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0738","name":"Portable gas oxygen system","description":"Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"01140","name":"Anes ntrplvabdmnl amputation","description":"Anesthesia for interpelviabdominal (hindquarter) amputation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.16,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"83663","name":"Fluoro polarize fetal lung","description":"Fetal lung maturity assessment; fluorescence polarization","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5513","name":"Multi den insert custom mold","description":"For diabetics only, multiple density insert, custom molded from model of patients foot, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77263","name":"Ther radiology tx plng cplx","description":"Therapeutic radiology treatment planning; complex","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":733.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1170","name":"Whlchr ampu fxd arm leg rest","description":"Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":"86294","name":"Immunoassay tumor qual","description":"Immunoassay for tumor antigen, qualitative or semiquantitative (eg, bladder tumor antigen)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":518.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0731","name":"Conductive garment for tens/","description":"Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patients skin by layers of fabric)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"J3320","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"88107","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"62360","name":"Insert spine infusion device","description":"Implantation or replacement of device for intrathecal or epidural drug infusion; subcutaneous reservoir","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":711.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0633","name":"Lso sc r pos/lat pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","date_of_service":"2026-05-10","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":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","date_of_service":"2026-05-10","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":"01996","name":"Dly hosp mgmt edrl rx admin","description":"Daily hospital management of epidural or subarachnoid continuous drug administration","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"86005","name":"Allg spec ige multiallg scr","description":"Allergen specific ige; qualitative, multiallergen screen (eg, disk, sponge, card)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"88182","name":"Cell marker study","description":"Flow cytometry, cell cycle or dna analysis","date_of_service":"2026-05-10","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":"69540","name":"Excision aural polyp","description":"Excision aural polyp","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-10","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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","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":"2026-05-10","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":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31601","name":"Planned tracheostomy<2 yrs","description":"Tracheostomy, planned (separate procedure); younger than 2 years","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35548","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1491.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1969.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1007.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6446","name":"Conform band s w>=3in <5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"78806","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"29899","name":"Ankle arthroscopy/surgery","description":"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; with ankle arthrodesis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25230","name":"Partial removal of radius","description":"Radial styloidectomy (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":557.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2138.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87147","name":"Culture type immunologic","description":"Culture, typing; immunologic method, other than immunofluorescence (eg, agglutination grouping), per antiserum","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27889","name":"Ankle disarticulation","description":"Ankle disarticulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97545","name":"Work hardening","description":"Work hardening/conditioning; initial 2 hours","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1242.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"J2150","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"47605","name":"Cholecystectomy w/cholang","description":"Cholecystectomy; with cholangiography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00145","name":"Anes px eye vitreortnl surg","description":"Anesthesia for procedures on eye; vitreoretinal surgery","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1445.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"35879","name":"Revise graft w/vein","description":"Revision, lower extremity arterial bypass, without thrombectomy, open; with vein patch angioplasty","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1163.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70545","name":"Mr angiography head w/dye","description":"Magnetic resonance angiography, head; with contrast material(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2510","name":"Th/wght bear quad-lat brim m","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80194","name":"Assay of quinidine","description":"Quinidine","date_of_service":"2026-05-10","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":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1212","name":"Dimethyl sulfoxide 50% 50 ml","description":"Injection, dmso, dimethyl sulfoxide, 50%, 50 ml","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1203.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","date_of_service":"2026-05-10","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":"92260","name":"Ophthalmodynamometry","description":"Ophthalmodynamometry","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35246","name":"Rpr blvsl vn grf ntrthrc w/o","description":"Repair blood vessel with vein graft; intrathoracic, without bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1858.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0984","name":"Add pwr tiller","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"78596","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"45170","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":802.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"J1610","name":"Glucagon hydrochloride/1 mg","description":"Injection, glucagon hydrochloride, per 1 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"78600","name":"Brain image < 4 views","description":"Brain imaging, less than 4 static views;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21076","name":"Impres&prep surg obt prosth","description":"Impression and custom preparation; surgical obturator prosthesis","date_of_service":"2026-05-10","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":"61512","name":"Crnec treph exc mngioma sttl","description":"Craniectomy, trephination, bone flap craniotomy; for excision of meningioma, supratentorial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"39400","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01212","name":"Anes open px hip jt disrtcj","description":"Anesthesia for open procedures involving hip joint; hip disarticulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"32997","name":"Total lung lavage","description":"Total lung lavage (unilateral)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2540","name":"Thigh/wght bear lacer molded","description":"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84550","name":"Assay of blood/uric acid","description":"Uric acid; blood","date_of_service":"2026-05-10","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":"83883","name":"Assay nephelometry not spec","description":"Nephelometry, each analyte not elsewhere specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84085","name":"Assay of rbc pg6d enzyme","description":"Phosphogluconate, 6-, dehydrogenase, rbc","date_of_service":"2026-05-10","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":"24164","name":"Removal prosth radial head","description":"Removal of prosthesis, includes debridement and synovectomy when performed; radial head","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70336","name":"Magnetic image jaw joint","description":"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["TC"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"64790","name":"Removal of nerve lesion","description":"Excision of neurofibroma or neurolemmoma; major peripheral nerve","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1040.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"93010","name":"Electrocardiogram report","description":"Electrocardiogram, routine ecg with at least 12 leads; interpretation and report only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"23474","name":"Revis reconst shoulder joint","description":"Revision of total shoulder arthroplasty, including allograft when performed; humeral and glenoid component","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1480.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31237","name":"Nsl/sins ndsc surg bx polypc","description":"Nasal/sinus endoscopy, surgical; with biopsy, polypectomy or debridement (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1201.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1050","name":"Whelchr fxd full length arms","description":"Fully-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"54120","name":"Partial removal of penis","description":"Amputation of penis; partial","date_of_service":"2026-05-10","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":"93451","name":"Right heart cath","description":"Right heart catheterization including measurement(s) of oxygen saturation and cardiac output, when performed","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"52700","name":"Drainage of prostate abscess","description":"Transurethral drainage of prostatic abscess","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1125.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27507","name":"Treatment of thigh fracture","description":"Open treatment of femoral shaft fracture with plate/screws, with or without cerclage","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"A6243","name":"Hydrogel drg >16<=48 w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2993","name":"Reteplase injection","description":"Injection, reteplase, 18.1 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"80502","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0419","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"93528","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"K0738","name":"Portable gas oxygen system","description":"Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["QB","RR","QF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"72069","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"72110","name":"X-ray exam l-2 spine 4/>vws","description":"Radiologic examination, spine, lumbosacral; minimum of 4 views","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74019","name":"Radex abdomen 2 views","description":"Radiologic examination, abdomen; 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33501","name":"Repair heart vessel fistula","description":"Repair of coronary arteriovenous or arteriocardiac chamber fistula; without cardiopulmonary bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66179","name":"Aqueous shunt eye w/o graft","description":"Aqueous shunt to extraocular equatorial plate reservoir, external approach; without graft","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"L8606","name":"Synthetic implnt urinary 1ml","description":"Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies","date_of_service":"2026-05-10","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":"95909","name":"Nrv cndj tst 5-6 studies","description":"Nerve conduction studies; 5-6 studies","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0783","name":"Programmable infusion pump","description":"Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KF"]}],"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":"2026-05-10","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":"43202","name":"Esophagoscopy flex biopsy","description":"Esophagoscopy, flexible, transoral; with biopsy, single or multiple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69720","name":"Release facial nerve","description":"Decompression facial nerve, intratemporal; lateral to geniculate ganglion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2107","name":"Spherocylinder 4.25d/12-2d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1016.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"A4652","name":"Microcapillary tube sealant","description":"Microcapillary tube sealant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"81274","name":"Htt gene charac alleles","description":"Htt (huntingtin) (eg, huntington disease) gene analysis; characterization of alleles (eg, expanded size)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71020","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78012","name":"Thyroid uptake measurement","description":"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)","date_of_service":"2026-05-10","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":"31766","name":"Carinal reconstruction","description":"Carinal reconstruction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1423.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61566","name":"Removal of brain tissue","description":"Craniotomy with elevation of bone flap; for selective amygdalohippocampectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2552.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"33030","name":"Partial removal of heart sac","description":"Pericardiectomy, subtotal or complete; without cardiopulmonary bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69700","name":"Close mastoid fistula","description":"Closure postauricular fistula, mastoid (separate procedure)","date_of_service":"2026-05-10","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":"84439","name":"Assay of free thyroxine","description":"Thyroxine; free","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"86619","name":"Borrelia antibody","description":"Antibody; borrelia (relapsing fever)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1634.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98942","name":"Chiropractic manj 5 regions","description":"Chiropractic manipulative treatment (cmt); spinal, 5 regions","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1091.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90657","name":"Iiv3 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","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":11.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"70460","name":"Ct head/brain w/dye","description":"Computed tomography, head or brain; with contrast material(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-05-10","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":"48545","name":"Pancreatorrhaphy","description":"Pancreatorrhaphy for injury","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1128.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85385","name":"Fibrinogen antigen","description":"Fibrinogen; antigen","date_of_service":"2026-05-10","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":"90759","name":"Hep b vac 3ag 10mcg 3 dos im","description":"Hepatitis b vaccine (hepb), 3-antigen (s, pre-s1, pre-s2), 10 mcg dosage, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","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":73.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49585","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":462.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.06,"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":"66020","name":"Injection treatment of eye","description":"Injection, anterior chamber of eye (separate procedure); air or liquid","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4410","name":"Ost skn barr extnd >4 sq","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-10","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":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65272","name":"Repair of eye wound","description":"Repair of laceration; conjunctiva, by mobilization and rearrangement, without hospitalization","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77065","name":"Dx mammo incl cad uni","description":"Diagnostic mammography, including computer-aided detection (cad) when performed; unilateral","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43754","name":"Dx gastr intub w/asp spec","description":"Gastric intubation and aspiration, diagnostic; single specimen (eg, acid analysis)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-10","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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1353.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A9535","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78226","name":"Hepatobiliary system imaging","description":"Hepatobiliary system imaging, including gallbladder when present;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45321","name":"Proctosigmoidoscopy volvul","description":"Proctosigmoidoscopy, rigid; with decompression of volvulus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64766","name":"Incise hip/thigh nerve","description":"Transection or avulsion of obturator nerve, intrapelvic, with or without adductor tenotomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":671.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","date_of_service":"2026-05-10","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":"61458","name":"Crnec sopl xpl/dcmpr crl nrv","description":"Craniectomy, suboccipital; for exploration or decompression of cranial nerves","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90812","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"68811","name":"Probe nasolacrimal duct","description":"Probing of nasolacrimal duct, with or without irrigation; requiring general anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58752","name":"Revise ovarian tube(s)","description":"Tubouterine implantation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1048.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77280","name":"Ther rad simulaj field smpl","description":"Therapeutic radiology simulation-aided field setting; simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1764.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"24930","name":"Amputation follow-up surgery","description":"Amputation, arm through humerus; re-amputation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":867.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74261","name":"Ct colonography dx","description":"Computed tomographic (ct) colonography, diagnostic, including image postprocessing; without contrast material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"84285","name":"Assay of silica","description":"Silica","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4373","name":"Skin barrier with flange","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":789.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95816","name":"Eeg awake and drowsy","description":"Electroencephalogram (eeg); including recording awake and drowsy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95912","name":"Nrv cndj test 11-12 studies","description":"Nerve conduction studies; 11-12 studies","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84060","name":"Assay acid phosphatase","description":"Phosphatase, acid; total","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"Q0035","name":"Cardiokymography","description":"Cardiokymography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78270","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1950","name":"Leuprolide acetate /3.75 mg","description":"Injection, leuprolide acetate (for depot suspension), per 3.75 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3049.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28050","name":"Biopsy of foot joint lining","description":"Arthrotomy with biopsy; intertarsal or tarsometatarsal joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27424","name":"Revision/removal of kneecap","description":"Reconstruction of dislocating patella; with patellectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1558.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99312","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"19291","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4049","name":"Finger splint, static","description":"Finger splint, static","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"S8100","name":"Spacer without mask","description":"Holding chamber or spacer for use with an inhaler or nebulizer; without mask","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4928","name":"Surgical mask","description":"Surgical mask, per 20","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"40701","name":"Repair cleft lip/nasal","description":"Plastic repair of cleft lip/nasal deformity; primary bilateral, 1-stage procedure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":957.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93024","name":"Ergonovine provocation test","description":"Ergonovine provocation test","date_of_service":"2026-05-10","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":"70110","name":"X-ray exam of jaw 4/> views","description":"Radiologic examination, mandible; complete, minimum of 4 views","date_of_service":"2026-05-10","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":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"J9020","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83570","name":"Assay of idh enzyme","description":"Isocitric dehydrogenase (idh)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33200","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":941.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"00796","name":"Anes iper upr abd lvr trnspl","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; liver transplant (recipient)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":790.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2050","name":"Hkafo torsion cable hip pelv","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom fabricated","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.38,"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":"33322","name":"Repair major blood vessel(s)","description":"Suture repair of aorta or great vessels; with cardiopulmonary bypass","date_of_service":"2026-05-10","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":"43855","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1776.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27140","name":"Transplant femur ridge","description":"Osteotomy and transfer of greater trochanter of femur (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"33762","name":"Shunt desc aorta to pulm art","description":"Shunt; descending aorta to pulmonary artery (potts-smith type operation)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1570.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"64713","name":"Revision of arm nerve(s)","description":"Neuroplasty, major peripheral nerve, arm or leg, open; brachial plexus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":840.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KF"]}],"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":"2026-05-10","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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77055","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"65450","name":"Treatment of corneal lesion","description":"Destruction of lesion of cornea by cryotherapy, photocoagulation or thermocauterization","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38241","name":"Transplt autol hct/donor","description":"Hematopoietic progenitor cell (hpc); autologous transplantation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5857","name":"Elec knee-shin swing only","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"A4397","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67036","name":"Removal of inner eye fluid","description":"Vitrectomy, mechanical, pars plana approach;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75790","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82248","name":"Bilirubin direct","description":"Bilirubin; direct","date_of_service":"2026-05-10","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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67570","name":"Decompress optic nerve","description":"Optic nerve decompression (eg, incision or fenestration of optic nerve sheath)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77082","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37232","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0035","name":"Cardiokymography","description":"Cardiokymography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92072","name":"Fitg c-lens keratoconus 1st","description":"Fitting of contact lens for management of keratoconus, initial fitting","date_of_service":"2026-05-10","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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2303","name":"Lens sphcy trifocal 4.0/.12-","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G9141","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67314","name":"Revise eye muscle","description":"Strabismus surgery, recession or resection procedure; 1 vertical muscle (excluding superior oblique)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":642.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1704.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92557","name":"Comprehensive hearing test","description":"Comprehensive audiometry threshold evaluation and speech recognition (92553 and 92556 combined)","date_of_service":"2026-05-10","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":"24000","name":"Arthrt elbw expl drg/rmvl fb","description":"Arthrotomy, elbow, including exploration, drainage, or removal of foreign body","date_of_service":"2026-05-10","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":"25111","name":"Remove wrist tendon lesion","description":"Excision of ganglion, wrist (dorsal or volar); primary","date_of_service":"2026-05-10","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":"64861","name":"Repair of arm nerves","description":"Suture of; brachial plexus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1610.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"13150","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36660","name":"Insertion catheter artery","description":"Catheterization, umbilical artery, newborn, for diagnosis or therapy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90375","name":"Rabies ig im/sc","description":"Rabies immune globulin (rig), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"57556","name":"Remove cervix repair bowel","description":"Excision of cervical stump, vaginal approach; with repair of enterocele","date_of_service":"2026-05-10","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":"84620","name":"Xylose tolerance test","description":"Xylose absorption test, blood and/or urine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":"23460","name":"Repair shoulder capsule","description":"Capsulorrhaphy, anterior, any type; with bone block","date_of_service":"2026-05-10","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":"58720","name":"Removal of ovary/tube(s)","description":"Salpingo-oophorectomy, complete or partial, unilateral or bilateral (separate procedure)","date_of_service":"2026-05-10","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":"72255","name":"Myelography thoracic spine","description":"Myelography, thoracic, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"63275","name":"Bx/exc xdrl spine lesn crvl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, cervical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1989.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","date_of_service":"2026-05-10","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":"L6028","name":"Part hand finger metacar amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s) /thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"78812","name":"Pet image skull-thigh","description":"Positron emission tomography (pet) imaging; skull base to mid-thigh","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0497","name":"Bat clps elec/comb vad, rep","description":"Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5102","name":"Bedside drain btl w/wo tube","description":"Bedside drainage bottle with or without tubing, rigid or expandable, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":954.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84520","name":"Assay of urea nitrogen","description":"Urea nitrogen; quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"K0734","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"53405","name":"Revise urethra stage 2","description":"Urethroplasty; second stage (formation of urethra), including urinary diversion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84022","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.68,"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":"84480","name":"Assay triiodothyronine (t3)","description":"Triiodothyronine t3; total (tt-3)","date_of_service":"2026-05-10","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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-10","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":"92579","name":"Visual audiometry (vra)","description":"Visual reinforcement audiometry (vra)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-10","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":"35452","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":"J7198","name":"Anti-inhibitor","description":"Anti-inhibitor, per i.u.","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75900","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86756","name":"Respiratory virus antibody","description":"Antibody; respiratory syncytial virus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":754.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86941","name":"Hemolysins/agglutinins","description":"Hemolysins and agglutinins; incubated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"50546","name":"Laparoscopic nephrectomy","description":"Laparoscopy, surgical; nephrectomy, including partial ureterectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1328.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"75970","name":"Vascular biopsy","description":"Transcatheter biopsy, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51045","name":"Incise bladder/drain ureter","description":"Cystotomy, with insertion of ureteral catheter or stent (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33947","name":"Ecmo/ecls initiation artery","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; initiation, veno-arterial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":822.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"93888","name":"Intracranial limited study","description":"Transcranial doppler study of the intracranial arteries; limited study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78805","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00632","name":"Anes px lumbar sympathectomy","description":"Anesthesia for procedures in lumbar region; lumbar sympathectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"45349","name":"Sigmoidoscopy w/resection","description":"Sigmoidoscopy, flexible; with endoscopic mucosal resection","date_of_service":"2026-05-10","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":"00352","name":"Anes px maj vsl nck smpl lig","description":"Anesthesia for procedures on major vessels of neck; simple ligation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"25332","name":"Revise wrist joint","description":"Arthroplasty, wrist, with or without interposition, with or without external or internal fixation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":706.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-10","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":"57291","name":"Construction of vagina","description":"Construction of artificial vagina; without graft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","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":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":680.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"26562","name":"Repair of web finger","description":"Repair of syndactyly (web finger) each web space; complex (eg, involving bone, nails)","date_of_service":"2026-05-10","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":"36832","name":"Av fistula revision open","description":"Revision, open, arteriovenous fistula; without thrombectomy, autogenous or nonautogenous dialysis graft (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"74320","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1036","name":"Patient transfer system >300","description":"Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"E1200","name":"Wheelchair amputee fixed arm","description":"Amputee wheelchair, fixed full length arms, swing away detachable footrest","date_of_service":"2026-05-10","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":"95860","name":"Needle emg 1 extremity","description":"Needle electromyography; 1 extremity with or without related paraspinal areas","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"00470","name":"Anes partial rib rescj nos","description":"Anesthesia for partial rib resection; not otherwise specified","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75733","name":"Artery x-rays adrenals","description":"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82530","name":"Cortisol free","description":"Cortisol; free","date_of_service":"2026-05-10","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":"67938","name":"Remove eyelid foreign body","description":"Removal of embedded foreign body, eyelid","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J2504","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1058.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1133.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0458","name":"Tlso 2mod symphis-xipho pre","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagitta","date_of_service":"2026-05-10","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":"85013","name":"Spun microhematocrit","description":"Blood count; spun microhematocrit","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6965","name":"Shldr disartic myoelectronic","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7031.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5590","name":"Prep ak ischial laminated","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"37785","name":"Ligate/divide/excise vein","description":"Ligation, division, and/or excision of varicose vein cluster(s), 1 leg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78466","name":"Heart infarct image","description":"Myocardial imaging, infarct avid, planar; qualitative or quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5859","name":"Knee-shin pro flex/ext cont","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6550","name":"Neg pres wound ther drsg set","description":"Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8606","name":"Synthetic implnt urinary 1ml","description":"Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"A4392","name":"Urinary pouch w st wear barr","description":"Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23655","name":"Cltx sho dslc w/mnpj w/anes","description":"Closed treatment of shoulder dislocation, with manipulation; requiring anesthesia","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"93990","name":"Doppler flow testing","description":"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow)","date_of_service":"2026-05-10","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":"67101","name":"Repair detached retina crtx","description":"Repair of retinal detachment, including drainage of subretinal fluid when performed; cryotherapy","date_of_service":"2026-05-10","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":"29845","name":"Wrist arthroscopy/surgery","description":"Arthroscopy, wrist, surgical; synovectomy, complete","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26410","name":"Repair hand tendon","description":"Repair, extensor tendon, hand, primary or secondary; without free graft, each tendon","date_of_service":"2026-05-10","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":"J0610","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"86781","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"43653","name":"Laparoscopy gastrostomy","description":"Laparoscopy, surgical; gastrostomy, without construction of gastric tube (eg, stamm procedure) (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75731","name":"Artery x-rays adrenal gland","description":"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85045","name":"Automated reticulocyte count","description":"Blood count; reticulocyte, automated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1600","name":"Gold sodium thiomaleate inj","description":"Injection, gold sodium thiomalate, up to 50 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1465.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"26843","name":"Fusion of hand joint","description":"Arthrodesis, carpometacarpal joint, digit, other than thumb, each;","date_of_service":"2026-05-10","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":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93582","name":"Perq transcath closure pda","description":"Percutaneous transcatheter closure of patent ductus arteriosus","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1542.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"27625","name":"Remove ankle joint lining","description":"Arthrotomy, with synovectomy, ankle;","date_of_service":"2026-05-10","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":"77290","name":"Ther rad simulaj field cplx","description":"Therapeutic radiology simulation-aided field setting; complex","date_of_service":"2026-05-10","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":"74329","name":"X-ray for pancreas endoscopy","description":"Endoscopic catheterization of the pancreatic ductal system, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1701.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"87492","name":"Chlmyd trach dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis, quantification","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"27062","name":"Remove femur lesion/bursa","description":"Excision; trochanteric bursa or calcification","date_of_service":"2026-05-10","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":"33207","name":"Insert heart pm ventricular","description":"Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); ventricular","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23066","name":"Biopsy shoulder tissues","description":"Biopsy, soft tissue of shoulder area; deep","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65930","name":"Remove blood clot from eye","description":"Removal of blood clot, anterior segment of eye","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4393","name":"Urine pch w ex wear bar conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"43453","name":"Dilate esophagus","description":"Dilation of esophagus, over guide wire","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88358","name":"Analysis tumor","description":"Morphometric analysis; tumor (eg, dna ploidy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"85048","name":"Automated leukocyte count","description":"Blood count; leukocyte (wbc), automated","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"86805","name":"Lymphocytotoxicity assay","description":"Lymphocytotoxicity assay, visual crossmatch; with titration","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92590","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":"92283","name":"Extnd color vision xm","description":"Color vision examination, extended, eg, anomaloscope or equivalent","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G0279","name":"Tomosynthesis, mammo","description":"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1736.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"68520","name":"Removal of tear sac","description":"Excision of lacrimal sac (dacryocystectomy)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A9556","name":"Ga67 gallium","description":"Gallium ga-67 citrate, diagnostic, per millicurie","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"83916","name":"Oligoclonal bands","description":"Oligoclonal immune (oligoclonal bands)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"78606","name":"Brain image w/flow 4 + views","description":"Brain imaging, minimum 4 static views; with vascular flow","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57330","name":"Repair bladder-vagina lesion","description":"Closure of vesicovaginal fistula; transvesical and vaginal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":840.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"71111","name":"X-ray exam ribs/chest4/> vws","description":"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","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":"77421","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":675.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46715","name":"Rep perf anoper fistu","description":"Repair of low imperforate anus; with anoperineal fistula (cut-back procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"66030","name":"Injection treatment of eye","description":"Injection, anterior chamber of eye (separate procedure); medication","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33418","name":"Repair tcat mitral valve","description":"Transcatheter mitral valve repair, percutaneous approach, including transseptal puncture when performed; initial prosthesis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2048.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"L3911","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"31708","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"90813","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"33735","name":"Revision of heart chamber","description":"Atrial septectomy or septostomy; closed heart (blalock-hanlon type operation)","date_of_service":"2026-05-10","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":"35601","name":"Bpg com crtd-ipsi int crtd","description":"Bypass graft, with other than vein; common carotid-ipsilateral internal carotid","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1285.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42160","name":"Treatment mouth roof lesion","description":"Destruction of lesion, palate or uvula (thermal, cryo or chemical)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-10","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":"24800","name":"Arthrodesis elbw joint local","description":"Arthrodesis, elbow joint; local","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":701.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72285","name":"Discography cerv/thor spine","description":"Discography, cervical or thoracic, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80195","name":"Assay of sirolimus","description":"Sirolimus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"75680","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":747.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"01844","name":"Anes vasc shunt/shunt revj","description":"Anesthesia for vascular shunt, or shunt revision, any type (eg, dialysis)","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":582.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21627","name":"Sternal debridement","description":"Sternal debridement","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":642.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"96372","name":"Ther/proph/diag inj sc/im","description":"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4422","name":"Ost pouch absorbent material","description":"Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each","date_of_service":"2026-05-10","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":"69501","name":"Mastoidectomy","description":"Transmastoid antrotomy (simple mastoidectomy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":847.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"54692","name":"Laparoscopy orchiopexy","description":"Laparoscopy, surgical; orchiopexy for intra-abdominal testis","date_of_service":"2026-05-10","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":"G0389","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15783","name":"Dermabrasion suprfl any site","description":"Dermabrasion; superficial, any site (eg, tattoo removal)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0122","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"77406","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"85549","name":"Muramidase","description":"Muramidase","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":"20957","name":"Mt bone graft microvasc","description":"Bone graft with microvascular anastomosis; metatarsal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3012.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2012.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99327","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2305","name":"Lens sphcy trifocal 4.0/4.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00 cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"68100","name":"Biopsy conjunctiva","description":"Biopsy of conjunctiva","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"79440","name":"Nuclear rx intra-articular","description":"Radiopharmaceutical therapy, by intra-articular administration","date_of_service":"2026-05-10","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":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47371","name":"Laparo ablate liver cryosurg","description":"Laparoscopy, surgical, ablation of 1 or more liver tumor(s); cryosurgical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28261","name":"Revision of foot tendon","description":"Capsulotomy, midfoot; with tendon lengthening","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50770","name":"Splicing of ureters","description":"Transureteroureterostomy, anastomosis of ureter to contralateral ureter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":933.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":670.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":523.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0296","name":"Hosp bed total elect w/ matt","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, with mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"27596","name":"Amputation follow-up surgery","description":"Amputation, thigh, through femur, any level; re-amputation","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4590","name":"Special casting material","description":"Special casting material (e.g., fiberglass)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2141.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"31536","name":"Laryngoscopy w/bx & op scope","description":"Laryngoscopy, direct, operative, with biopsy; with operating microscope or telescope","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"70548","name":"Mr angiography neck w/dye","description":"Magnetic resonance angiography, neck; with contrast material(s)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70371","name":"Speech evaluation complex","description":"Complex dynamic pharyngeal and speech evaluation by cine or video recording","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11752","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"63709","name":"Repair spinal fluid leakage","description":"Repair of dural/cerebrospinal fluid leak or pseudomeningocele, with laminectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"89141","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"42305","name":"Drainage of salivary gland","description":"Drainage of abscess; parotid, complicated","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"31600","name":"Planned tracheostomy","description":"Tracheostomy, planned (separate procedure);","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"74290","name":"Contrast x-ray gallbladder","description":"Cholecystography, oral contrast","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"49429","name":"Removal of shunt","description":"Removal of peritoneal-venous shunt","date_of_service":"2026-05-10","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":"84580","name":"Assay of urine urobilinogen","description":"Urobilinogen, urine; quantitative, timed specimen","date_of_service":"2026-05-10","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":"27253","name":"Treat hip dislocation","description":"Open treatment of hip dislocation, traumatic, without internal fixation","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","date_of_service":"2026-05-10","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":"28415","name":"Optx calcaneal fracture","description":"Open treatment of calcaneal fracture, includes internal fixation, when performed;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"83021","name":"Hemoglobin chromotography","description":"Hemoglobin fractionation and quantitation; chromatography (eg, a2, s, c, and/or f)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0572","name":"Aerosol compressor adjust pr","description":"Aerosol compressor, adjustable pressure, light duty for intermittent use","date_of_service":"2026-05-10","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":"E1070","name":"Wheelchair detachable foot r","description":"Fully-reclining wheelchair, detachable arms (desk or full length) swing away detachable footrest","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1132.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23931","name":"I&d upr a/e bursa","description":"Incision and drainage, upper arm or elbow area; bursa","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"00800","name":"Anes px lwr ant abdl wal nos","description":"Anesthesia for procedures on lower anterior abdominal wall; not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"43328","name":"Esoph fundoplasty thor","description":"Esophagogastric fundoplasty partial or complete; thoracotomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82600","name":"Assay of cyanide","description":"Cyanide","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":794.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86666","name":"Ehrlichia antibody","description":"Antibody; ehrlichia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"52450","name":"Transurethral inc prostate","description":"Transurethral incision of prostate","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00620","name":"Anes px thrc spine&cord nos","description":"Anesthesia for procedures on thoracic spine and cord, not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-10","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":"00100","name":"Anes px salivary gland w/bx","description":"Anesthesia for procedures on salivary glands, including biopsy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"L8642","name":"Hallux implant","description":"Hallux implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"19112","name":"Excise breast duct fistula","description":"Excision of lactiferous duct fistula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59871","name":"Remove cerclage suture","description":"Removal of cerclage suture under anesthesia (other than local)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1096.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"00632","name":"Anes px lumbar sympathectomy","description":"Anesthesia for procedures in lumbar region; lumbar sympathectomy","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"19340","name":"Insj breast implt sm d mast","description":"Insertion of breast implant on same day of mastectomy (ie, immediate)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28636","name":"Treat toe dislocation","description":"Percutaneous skeletal fixation of metatarsophalangeal joint dislocation, with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"37609","name":"Ligation/bx temporal artery","description":"Ligation or biopsy, temporal artery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8509","name":"Trach-esoph voice pros md in","description":"Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5781","name":"Lower limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system","date_of_service":"2026-05-10","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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-10","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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70486","name":"Ct maxillofacial w/o dye","description":"Computed tomography, maxillofacial area; without contrast material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","date_of_service":"2026-05-10","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":"46740","name":"Construction of absent anus","description":"Repair of high imperforate anus with rectourethral or rectovaginal fistula; perineal or sacroperineal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4301","name":"Implantable access syst perc","description":"Implantable access total catheter, port/reservoir (e.g., venous, arterial, epidural, subarachnoid, peritoneal, etc.)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83690","name":"Assay of lipase","description":"Lipase","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2222.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64823","name":"Sympathectomy supfc palmar","description":"Sympathectomy; superficial palmar arch","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":910.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27140","name":"Transplant femur ridge","description":"Osteotomy and transfer of greater trochanter of femur (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1081.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"47136","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4613.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","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":"36870","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82726","name":"Long chain fatty acids","description":"Very long chain fatty acids","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"30130","name":"Excise inferior turbinate","description":"Excision inferior turbinate, partial or complete, any method","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"47561","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86406","name":"Particle agglut antbdy titr","description":"Particle agglutination; titer, each antibody","date_of_service":"2026-05-10","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":"21034","name":"Excise max/zygoma mal tumor","description":"Excision of malignant tumor of maxilla or zygoma","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1370.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"92572","name":"Staggered spondaic word test","description":"Staggered spondaic word test","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"J9300","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2203.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J0288","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43228","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"34803","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1588.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"S8265","name":"Haberman feeder","description":"Haberman feeder for cleft lip/palate","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0249","name":"Pad water circulating heat u","description":"Pad for water circulating heat unit, for replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":771.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00567","name":"Anes direct cabg w/pump","description":"Anesthesia for direct coronary artery bypass grafting; with pump oxygenator","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.94,"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":"58563","name":"Hysteroscopy ablation","description":"Hysteroscopy, surgical; with endometrial ablation (eg, endometrial resection, electrosurgical ablation, thermoablation)","date_of_service":"2026-05-10","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":"25100","name":"Biopsy of wrist joint","description":"Arthrotomy, wrist joint; with biopsy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L7261","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"K0602","name":"Repl batt silver oxide 3 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29240","name":"Strapping of shoulder","description":"Strapping; shoulder (eg, velpeau)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":"25909","name":"Amputation follow-up surgery","description":"Amputation, forearm, through radius and ulna; re-amputation","date_of_service":"2026-05-10","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":"67830","name":"Revise eyelashes","description":"Correction of trichiasis; incision of lid margin","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37620","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3961","name":"Sewho cap design w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"57250","name":"Repair rectum & vagina","description":"Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86711","name":"John cunningham antibody","description":"Antibody; jc (john cunningham) virus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"00820","name":"Anes px lwr post abdl wall","description":"Anesthesia for procedures on lower posterior abdominal wall","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24352","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91132","name":"Electrogastrography","description":"Electrogastrography, diagnostic, transcutaneous;","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"27425","name":"Lat retinacular release open","description":"Lateral retinacular release, open","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"95866","name":"Needle emg hemidiaphragm","description":"Needle electromyography; hemidiaphragm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22590","name":"Arthrd pst tq craniocervical","description":"Arthrodesis, posterior technique, craniocervical (occiput-c2)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58543","name":"Lsh uterus above 250 g","description":"Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75885","name":"Vein x-ray liver w/hemodynam","description":"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"S4989","name":"Contracept iud","description":"Contraceptive intrauterine device (e.g., progestacert iud), including implants and supplies","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85461","name":"Hemoglobin fetal","description":"Hemoglobin or rbcs, fetal, for fetomaternal hemorrhage; rosette","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"G0326","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","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":"73562","name":"X-ray exam of knee 3","description":"Radiologic examination, knee; 3 views","date_of_service":"2026-05-10","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":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":"42508","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28286","name":"Repair of hammertoe","description":"Correction, cock-up fifth toe, with plastic skin closure (eg, ruiz-mora type procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":377.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-10","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":"15931","name":"Exc sacral pr ulc prim sutr","description":"Excision, sacral pressure ulcer, with primary suture;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2202","name":"Lens sphere bifocal 7.12-20.","description":"Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens","date_of_service":"2026-05-10","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":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27060","name":"Removal of ischial bursa","description":"Excision; ischial bursa","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80188","name":"Assay of primidone","description":"Primidone","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73610","name":"X-ray exam of ankle","description":"Radiologic examination, ankle; complete, minimum of 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92522","name":"Evaluate speech production","description":"Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria);","date_of_service":"2026-05-10","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":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31510","name":"Laryngoscopy with biopsy","description":"Laryngoscopy, indirect; with biopsy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-10","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":"84484","name":"Assay of troponin quant","description":"Troponin, quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","date_of_service":"2026-05-10","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":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1372","name":"Oxy suppl heater for nebuliz","description":"Immersion external heater for nebulizer","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0692","name":"Uvl sys panel 4 ft","description":"Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 4 foot panel","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"95903","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45540","name":"Correct rectal prolapse","description":"Proctopexy (eg, for prolapse); abdominal approach","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"92562","name":"Loudness balance test","description":"Loudness balance test, alternate binaural or monaural","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":626.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78264","name":"Gastric emptying img study","description":"Gastric emptying imaging study (eg, solid, liquid, or both);","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"85130","name":"Chromogenic substrate assay","description":"Chromogenic substrate assay","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4039.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["KF"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79403","name":"Hematopoietic nuclear tx","description":"Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous infusion","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4660","name":"Sphyg/bp app w cuff and stet","description":"Sphygmomanometer/blood pressure apparatus with cuff and stethoscope","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"S0610","name":"Annual gynecological examina","description":"Annual gynecological examination, new patient","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1039","name":"Transport chair pt wt >300lb","description":"Transport chair, adult size, heavy duty, patient weight capacity greater than 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"23000","name":"Rmvl sbdltd clcreous dep opn","description":"Removal of subdeltoid calcareous deposits, open","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63282","name":"Bx/exc idrl spine lesn lmbr","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, lumbar","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0602","name":"Repl batt silver oxide 3 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1196.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0190","name":"Cerv collar supp adj cerv ba","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31656","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87143","name":"Culture typing glc/hplc","description":"Culture, typing; gas liquid chromatography (glc) or high pressure liquid chromatography (hplc) method","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72240","name":"Myelography neck spine","description":"Myelography, cervical, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25430","name":"Vasc graft into carpal bone","description":"Insertion of vascular pedicle into carpal bone (eg, hori procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33426","name":"Repair of mitral valve","description":"Valvuloplasty, mitral valve, with cardiopulmonary bypass; with prosthetic ring","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2468.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26535","name":"Revise finger joint","description":"Arthroplasty, interphalangeal joint; each joint","date_of_service":"2026-05-10","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":"19357","name":"Tiss xpndr plmt brst rcnstj","description":"Tissue expander placement in breast reconstruction, including subsequent expansion(s)","date_of_service":"2026-05-10","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":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2230.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5150","name":"Mold sckt ext knee shin sach","description":"Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78300","name":"Bone imaging limited area","description":"Bone and/or joint imaging; limited area","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"78461","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93770","name":"Determination venous press","description":"Determination of venous pressure","date_of_service":"2026-05-10","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":"28008","name":"Incision of foot fascia","description":"Fasciotomy, foot and/or toe","date_of_service":"2026-05-10","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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3906","name":"Who w/o joints cf","description":"Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33464","name":"Valvuloplasty tricuspid","description":"Valvuloplasty, tricuspid valve; with ring insertion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":392.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36680","name":"Insert needle bone cavity","description":"Placement of needle for intraosseous infusion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23106","name":"Arthrotomy strnclav joint","description":"Arthrotomy; sternoclavicular joint, with synovectomy, with or without biopsy","date_of_service":"2026-05-10","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":"27286","name":"Arthrd hip jt sbtrchc osteot","description":"Arthrodesis, hip joint (including obtaining graft); with subtrochanteric osteotomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1907.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","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":"74305","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"53200","name":"Biopsy of urethra","description":"Biopsy of urethra","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","date_of_service":"2026-05-10","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":"41016","name":"Drainage of mouth lesion","description":"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; submental","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28315","name":"Removal of sesamoid bone","description":"Sesamoidectomy, first toe (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25535","name":"Cltx ulnar shft fx w/mnpj","description":"Closed treatment of ulnar shaft fracture; with manipulation","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"79005","name":"Nuclear rx oral admin","description":"Radiopharmaceutical therapy, by oral administration","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1913.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2390.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"72080","name":"X-ray exam thoracolmb 2/> vw","description":"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71035","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93970","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"31360","name":"Removal of larynx","description":"Laryngectomy; total, without radical neck dissection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1556.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"27093","name":"Injection for hip x-ray","description":"Injection procedure for hip arthrography; without anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29895","name":"Ankle arthroscopy/surgery","description":"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; synovectomy, partial","date_of_service":"2026-05-10","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":"32500","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1687.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3260","name":"Tobramycin sulfate injection","description":"Injection, tobramycin sulfate, up to 80 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"69820","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95864","name":"Needle emg 4 extremities","description":"Needle electromyography; 4 extremities with or without related paraspinal areas","date_of_service":"2026-05-10","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":"87197","name":"Serum bactericidal titer","description":"Serum bactericidal titer (schlichter test)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"23490","name":"Reinforce clavicle","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; clavicle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7503","name":"Hmes filter holder or cap","description":"Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"44207","name":"L colectomy/coloproctostomy","description":"Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21685","name":"Hyoid myotomy & suspension","description":"Hyoid myotomy and suspension","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1071.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"J9263","name":"Oxaliplatin","description":"Injection, oxaliplatin, 0.5 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1592.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1832","name":"Ko adj jnt pos r sup pre cst","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"10022","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","date_of_service":"2026-05-10","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":"30430","name":"Revision of nose","description":"Rhinoplasty, secondary; minor revision (small amount of nasal tip work)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1109.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0012","name":"Ltwt portbl power whlchr","description":"Lightweight portable motorized/power wheelchair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"44650","name":"Repair bowel fistula","description":"Closure of enteroenteric or enterocolic fistula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1523.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1763.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-10","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":"78120","name":"Red cell mass single","description":"Red cell volume determination (separate procedure); single sampling","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"30468","name":"Rpr nsl vlv collapse w/implt","description":"Repair of nasal valve collapse with subcutaneous/submucosal lateral wall implant(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":789.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-05-10","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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76120","name":"Cine/video x-rays","description":"Cineradiography/videoradiography, except where specifically included","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95813","name":"Eeg extnd mntr 61-119 min","description":"Electroencephalogram (eeg) extended monitoring; 61-119 minutes","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86382","name":"Neutralization test viral","description":"Neutralization test, viral","date_of_service":"2026-05-10","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":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"49655","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"J8510","name":"Oral busulfan","description":"Busulfan; oral, 2 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"84432","name":"Assay of thyroglobulin","description":"Thyroglobulin","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1230","name":"Methadone injection","description":"Injection, methadone hcl, up to 10 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A9561","name":"Tc99m oxidronate","description":"Technetium tc-99m oxidronate, diagnostic, per study dose, up to 30 millicuries","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2113","name":"Spherocylindr 7.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"29715","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"27732","name":"Repair of fibula epiphysis","description":"Arrest, epiphyseal (epiphysiodesis), open; distal fibula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"75880","name":"Vein x-ray eye socket","description":"Venography, orbital, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"24615","name":"Optx aqt/chrnc elbow dislc","description":"Open treatment of acute or chronic elbow dislocation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3760","name":"Eo adj jt prefab custom fit","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific  patient by an individual with expertise","date_of_service":"2026-05-10","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":"77280","name":"Ther rad simulaj field smpl","description":"Therapeutic radiology simulation-aided field setting; simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","date_of_service":"2026-05-10","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":"A6233","name":"Hydrogel dressing >48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28505","name":"Treat big toe fracture","description":"Open treatment of fracture, great toe, phalanx or phalanges, includes internal fixation, when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85014","name":"Hematocrit","description":"Blood count; hematocrit (hct)","date_of_service":"2026-05-10","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":"95863","name":"Needle emg 3 extremities","description":"Needle electromyography; 3 extremities with or without related paraspinal areas","date_of_service":"2026-05-10","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":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"37228","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49322","name":"Laparoscopy aspiration","description":"Laparoscopy, surgical; with aspiration of cavity or cyst (eg, ovarian cyst) (single or multiple)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"67810","name":"Incal bx eyelid skn lid mrgn","description":"Incisional biopsy of eyelid skin including lid margin","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"76820","name":"Umbilical artery echo","description":"Doppler velocimetry, fetal; umbilical artery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1024.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0241","name":"Bath tub wall rail","description":"Bath tub wall rail, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"A7034","name":"Nasal application device","description":"Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35281","name":"Rpr blvsl gr ot/th vn ntr-ab","description":"Repair blood vessel with graft other than vein; intra-abdominal","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"67903","name":"Repair eyelid defect","description":"Repair of blepharoptosis; (tarso) levator resection or advancement, internal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33216","name":"Insert 1 electrode pm-defib","description":"Insertion of a single transvenous electrode, permanent pacemaker or implantable defibrillator","date_of_service":"2026-05-10","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":"01965","name":"Anes incompl/missed ab px","description":"Anesthesia for incomplete or missed abortion procedures","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"A4425","name":"Ost pch drain for barrier fl","description":"Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-05-10","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":"01160","name":"Anes clsd px symph pub/si jt","description":"Anesthesia for closed procedures involving symphysis pubis or sacroiliac joint","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86774","name":"Tetanus antibody","description":"Antibody; tetanus","date_of_service":"2026-05-10","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":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"31086","name":"Removal of frontal sinus","description":"Sinusotomy frontal; nonobliterative, with osteoplastic flap, brow incision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1226.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"29025","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"62192","name":"Establish brain cavity shunt","description":"Creation of shunt; subarachnoid/subdural-peritoneal, -pleural, other terminus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"J7344","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"80201","name":"Assay of topiramate","description":"Topiramate","date_of_service":"2026-05-10","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":"31588","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2421.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"63702","name":"Repair of spinal herniation","description":"Repair of meningocele; larger than 5 cm diameter","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28171","name":"Resect tarsal tumor","description":"Radical resection of tumor; tarsal (except talus or calcaneus)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":735.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29715","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L3807","name":"Whfo w/o joints pre cst","description":"Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6445","name":"Conform band s w <3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard","date_of_service":"2026-05-10","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":"L3927","name":"Fo pip dip no jt spr pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36510","name":"Insertion of catheter vein","description":"Catheterization of umbilical vein for diagnosis or therapy, newborn","date_of_service":"2026-05-10","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":"23530","name":"Optx strnclav dislc aqt/chrn","description":"Open treatment of sternoclavicular dislocation, acute or chronic;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":658.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1171","name":"Wheelchair amputee w/o leg r","description":"Amputee wheelchair, fixed full length arms, without footrests or legrest","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91034","name":"Gastroesophageal reflux test","description":"Esophagus, gastroesophageal reflux test; with nasal catheter ph electrode(s) placement, recording, analysis and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56700","name":"Prtl hymnctmy/revj hymnl rng","description":"Partial hymenectomy or revision of hymenal ring","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78647","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75946","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1595.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"Q0506","name":"Lith-ion batt elec/pneum vad","description":"Battery, lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"80173","name":"Assay of haloperidol","description":"Haloperidol","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33472","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1699.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57200","name":"Repair of vagina","description":"Colporrhaphy, suture of injury of vagina (nonobstetrical)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q2007","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"42900","name":"Repair throat wound","description":"Suture pharynx for wound or injury","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"86706","name":"Hep b surface antibody","description":"Hepatitis b surface antibody (hbsab)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"42650","name":"Dilation of salivary duct","description":"Dilation salivary duct","date_of_service":"2026-05-10","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":"01215","name":"Anes opn revj tot hip arthrp","description":"Anesthesia for open procedures involving hip joint; revision of total hip arthroplasty","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48510","name":"Drain pancreatic pseudocyst","description":"External drainage, pseudocyst of pancreas, open","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1050.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"89329","name":"Sperm evaluation test","description":"Sperm evaluation; hamster penetration test","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44100","name":"Biopsy of bowel","description":"Biopsy of intestine by capsule, tube, peroral (1 or more specimens)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"J2180","name":"Meperidine/promethazine inj","description":"Injection, meperidine and promethazine hcl, up to 50 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77326","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"59140","name":"Treat ectopic pregnancy","description":"Surgical treatment of ectopic pregnancy; cervical, with evacuation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A4392","name":"Urinary pouch w st wear barr","description":"Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-10","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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A6450","name":"Lt compres band >=5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99150","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"76978","name":"Us trgt dyn mbubb 1st les","description":"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5450","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1518.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28800","name":"Amputation of midfoot","description":"Amputation, foot; midtarsal (eg, chopart type procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37206","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2842.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54900","name":"Fusion of spermatic ducts","description":"Epididymovasostomy, anastomosis of epididymis to vas deferens; unilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":869.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":561.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"62146","name":"Crnop w/autograft<5 cm diam","description":"Cranioplasty with autograft (includes obtaining bone grafts); up to 5 cm diameter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78013","name":"Thyroid imaging w/blood flow","description":"Thyroid imaging (including vascular flow, when performed);","date_of_service":"2026-05-10","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":"43262","name":"Endo cholangiopancreatograph","description":"Endoscopic retrograde cholangiopancreatography (ercp); with sphincterotomy/papillotomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"64774","name":"Remove skin nerve lesion","description":"Excision of neuroma; cutaneous nerve, surgically identifiable","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"S8999","name":"Resuscitation bag","description":"Resuscitation bag (for use by patient on artificial respiration during power failure or other catastrophic event)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1298","name":"Wheelchair spec seat depth/w","description":"Special wheelchair seat depth and/or width, by construction","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8582.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"53660","name":"Dilation of urethra","description":"Dilation of female urethra including suppository and/or instillation; initial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":481.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0737","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0737","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2153.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1157.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1620","name":"Ho flex pavlik harns pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","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":"L3763","name":"Ewho rigid w/o jnts cf","description":"Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":906.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":683.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22852","name":"Remove spine fixation device","description":"Removal of posterior segmental instrumentation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":812.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":529.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1717","name":"Brachytx, non-str,hdr ir-192","description":"Brachytherapy source, non-stranded, high dose rate iridium-192, per source","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"M0245","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"39200","name":"Resect mediastinal cyst","description":"Resection of mediastinal cyst","date_of_service":"2026-05-10","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":"47500","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"24100","name":"Arthrt elbw synovial bx only","description":"Arthrotomy, elbow; with synovial biopsy only","date_of_service":"2026-05-10","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":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54438","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28308","name":"Incision of metatarsal","description":"Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; other than first metatarsal, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"71101","name":"X-ray exam unilat ribs/chest","description":"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":821.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0640","name":"Lso s/c shell/panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":942.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":582.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90689","name":"Vacc iiv4 no prsrv 0.25ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), inactivated, adjuvanted, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7110","name":"Dextran 75 infusion","description":"Infusion, dextran 75, 500 ml","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"19291","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"21081","name":"Impres&prep mndbl res prosth","description":"Impression and custom preparation; mandibular resection prosthesis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2211","name":"Lens sphcy bifo 7.25-12/.25-","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":934.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"L1902","name":"Afo ankle gauntlet pre ots","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":"E0217","name":"Water circ heat pad w pump","description":"Water circulating heat pad with pump","date_of_service":"2026-05-10","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":"A4385","name":"Ost skn barrier sld ext wear","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each","date_of_service":"2026-05-10","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":"E1222","name":"Wheelchair spec size w/ leg","description":"Wheelchair with fixed arm, elevating legrests","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75662","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"80152","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G6004","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42809","name":"Remove pharynx foreign body","description":"Removal of foreign body from pharynx","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-10","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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"L5840","name":"Multi-axial knee/shin system","description":"Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"27880","name":"Amputation of lower leg","description":"Amputation, leg, through tibia and fibula;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":934.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"45560","name":"Repair of rectocele","description":"Repair of rectocele (separate procedure)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A5055","name":"Stoma cap","description":"Stoma cap","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2103.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88311","name":"Decalcify tissue","description":"Decalcification procedure (list separately in addition to code for surgical pathology examination)","date_of_service":"2026-05-10","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":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0160","name":"Cerv sr wire occ/man pre ots","description":"Cervical, semi-rigid, wire frame occipital/mandibular support, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6210","name":"Foam drg >16<=48 sq in w/o b","description":"Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","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":"32095","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"64418","name":"Njx aa&/strd sprscap nrv","description":"Injection(s), anesthetic agent(s) and/or steroid; suprascapular nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"85610","name":"Prothrombin time","description":"Prothrombin time;","date_of_service":"2026-05-10","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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93511","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27280","name":"Arthr si jt opn b1grf instrm","description":"Arthrodesis, sacroiliac joint, open, includes obtaining bone graft, including instrumentation, when performed","date_of_service":"2026-05-10","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":"75705","name":"Artery x-rays spine","description":"Angiography, spinal, selective, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86003","name":"Allg spec ige crude xtrc ea","description":"Allergen specific ige; quantitative or semiquantitative, crude allergen extract, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6712","name":"Ped term dev, hook, vol clos","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"31635","name":"Bronchoscopy w/fb removal","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal of foreign body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2108.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78111","name":"Plasma volume multiple","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0635","name":"Patient lift electric","description":"Patient lift, electric with seat or sling","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27392","name":"Incision of thigh tendons","description":"Tenotomy, open, hamstring, knee to hip; multiple tendons, bilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22521","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["26"]}],"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":"2026-05-10","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":"59866","name":"Abortion (mpr)","description":"Multifetal pregnancy reduction(s) (mpr)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88267","name":"Chromosome analys placenta","description":"Chromosome analysis, amniotic fluid or chorionic villus, count 15 cells, 1 karyotype, with banding","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"26530","name":"Revise knuckle joint","description":"Arthroplasty, metacarpophalangeal joint; each joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3806","name":"Whfo w/joint(s) custom fab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":"66840","name":"Removal of lens material","description":"Removal of lens material; aspiration technique, 1 or more stages","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"49082","name":"Abd paracentesis","description":"Abdominal paracentesis (diagnostic or therapeutic); without imaging guidance","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"47380","name":"Open ablate liver tumor rf","description":"Ablation, open, of 1 or more liver tumor(s); radiofrequency","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1559.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"57310","name":"Repair urethrovaginal lesion","description":"Closure of urethrovaginal fistula;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33545","name":"Repair of heart damage","description":"Repair of postinfarction ventricular septal defect, with or without myocardial resection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37209","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6217","name":"Non-sterile gauze>16<=48 sq","description":"Gauze, non-impregnated, non-sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92546","name":"Sinusoidal rotational test","description":"Sinusoidal vertical axis rotational testing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36015","name":"Place catheter in artery","description":"Selective catheter placement, segmental or subsegmental pulmonary artery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":854.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"70010","name":"Contrast x-ray of brain","description":"Myelography, posterior fossa, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"97022","name":"Whirlpool therapy","description":"Application of a modality to 1 or more areas; whirlpool","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1214.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96103","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83874","name":"Assay of myoglobin","description":"Myoglobin","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"23222","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1980.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3675","name":"So vest canvas/web pre ots","description":"Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"65450","name":"Treatment of corneal lesion","description":"Destruction of lesion of cornea by cryotherapy, photocoagulation or thermocauterization","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61538","name":"Removal of brain tissue","description":"Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, with electrocorticography during surgery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"89220","name":"Sputum specimen collection","description":"Sputum, obtaining specimen, aerosol induced technique (separate procedure)","date_of_service":"2026-05-10","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":"A4413","name":"2 pc drainable ost pouch","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"31300","name":"Removal of larynx lesion","description":"Laryngotomy (thyrotomy, laryngofissure), with removal of tumor or laryngocele, cordectomy","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93701","name":"Bioimpedance cv analysis","description":"Bioimpedance-derived physiologic cardiovascular analysis","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"G2064","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"19370","name":"Revj peri-implt capsule brst","description":"Revision of peri-implant capsule, breast, including capsulotomy, capsulorrhaphy, and/or partial capsulectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"89225","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"34826","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1441","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","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":"E0628","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"77082","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"92352","name":"Fit aphakia spectcl monofocl","description":"Fitting of spectacle prosthesis for aphakia; monofocal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53502","name":"Repair of urethra injury","description":"Urethrorrhaphy, suture of urethral wound or injury, female","date_of_service":"2026-05-10","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":"76641","name":"Ultrasound breast complete","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"88365","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; initial single probe stain procedure","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6950","name":"Above elbow switch control","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15953","name":"Exc trchntr pr ulc flp ostc","description":"Excision, trochanteric pressure ulcer, with skin flap closure; with ostectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1175.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73050","name":"X-ray exam of shoulders","description":"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction","date_of_service":"2026-05-10","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":"E0433","name":"Portable liquid oxygen sys","description":"Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["MS"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26075","name":"Explore/treat finger joint","description":"Arthrotomy, with exploration, drainage, or removal of loose or foreign body; metacarpophalangeal joint, each","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":"55180","name":"Revision of scrotum","description":"Scrotoplasty; complicated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5858","name":"Stance phase only","description":"Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","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":"27650","name":"Repair achilles tendon","description":"Repair, primary, open or percutaneous, ruptured achilles tendon;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84132","name":"Assay of serum potassium","description":"Potassium; serum, plasma or whole blood","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"23220","name":"Radical rescj tumor prox hum","description":"Radical resection of tumor, proximal humerus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1267.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5048.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"51784","name":"Anal/urinary muscle study","description":"Electromyography studies (emg) of anal or urethral sphincter, other than needle, any technique","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":"21920","name":"Biopsy soft tissue of back","description":"Biopsy, soft tissue of back or flank; superficial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15940","name":"Exc ischial pr ulc prim sutr","description":"Excision, ischial pressure ulcer, with primary suture;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":758.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2459.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6026","name":"Part hand myo exclu term dev","description":"Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device, excludes terminal device(s)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1149.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"51792","name":"Urinary reflex study","description":"Stimulus evoked response (eg, measurement of bulbocavernosus reflex latency time)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1360.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"64413","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85610","name":"Prothrombin time","description":"Prothrombin time;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A6251","name":"Absorpt drg <=16 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-10","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":"82950","name":"Glucose test","description":"Glucose; post glucose dose (includes glucose)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0174","name":"Cerv sr 2pc thor ext pre ots","description":"Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82376","name":"Assay carboxyhb qual","description":"Carboxyhemoglobin; qualitative","date_of_service":"2026-05-10","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":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2625.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76377","name":"3d render w/intrp postproces","description":"3d rendering with interpretation and reporting of computed tomography, magnetic resonance imaging, ultrasound, or other tomographic modality with image postprocessing under concurrent supervision; requiring image postprocessing on an independent workstation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":622.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86355","name":"B cells total count","description":"B cells, total count","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35646","name":"Bpg aortobifemoral","description":"Bypass graft, with other than vein; aortobifemoral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2166.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"72069","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3000","name":"Streptomycin injection","description":"Injection, streptomycin, up to 1 gm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","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":"2026-05-10","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":"49906","name":"Free omental flap microvasc","description":"Free omental flap with microvascular anastomosis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":903.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52325","name":"Cystoscopy stone removal","description":"Cystourethroscopy (including ureteral catheterization); with fragmentation of ureteral calculus (eg, ultrasonic or electro-hydraulic technique)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6238","name":"Hydrocolld drg >16<=48 w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","date_of_service":"2026-05-10","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":"95908","name":"Nrv cndj tst 3-4 studies","description":"Nerve conduction studies; 3-4 studies","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00922","name":"Anes px male gent sem ves","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); seminal vesicles","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77403","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1379.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99263","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1939.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"50365","name":"Rnl altrnsplj w/rcp nfrct","description":"Renal allotransplantation, implantation of graft; with recipient nephrectomy","date_of_service":"2026-05-10","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":"57300","name":"Repair rectum-vagina fistula","description":"Closure of rectovaginal fistula; vaginal or transanal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01670","name":"Anes all px vn shoulder&ax","description":"Anesthesia for all procedures on veins of shoulder and axilla","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62190","name":"Establish brain cavity shunt","description":"Creation of shunt; subarachnoid/subdural-atrial, -jugular, -auricular","date_of_service":"2026-05-10","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":"86638","name":"Q fever antibody","description":"Antibody; coxiella burnetii (q fever)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3973","name":"Sewho airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1659.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84132","name":"Assay of serum potassium","description":"Potassium; serum, plasma or whole blood","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1398.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27591","name":"Amputate leg at thigh","description":"Amputation, thigh, through femur, any level; immediate fitting technique including first cast","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4412","name":"Ost pouch drain high output","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"J3070","name":"Pentazocine injection","description":"Injection, pentazocine, 30 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1990","name":"Afo doub solid stirrup calf","description":"Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar bk orthosis), custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1180","name":"Wheelchair amputee w/ foot r","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable footrests","date_of_service":"2026-05-10","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":"27179","name":"Revise head/neck of femur","description":"Open treatment of slipped femoral epiphysis; osteoplasty of femoral neck (heyman type procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1150.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.6,"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":"33735","name":"Revision of heart chamber","description":"Atrial septectomy or septostomy; closed heart (blalock-hanlon type operation)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"24935","name":"Revision of amputation","description":"Stump elongation, upper extremity","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1152.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":392.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21032","name":"Remove exostosis maxilla","description":"Excision of maxillary torus palatinus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"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":"2026-05-10","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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","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":"76101","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0324","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78290","name":"Intestine imaging","description":"Intestine imaging (eg, ectopic gastric mucosa, meckels localization, volvulus)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23400","name":"Fixation of shoulder blade","description":"Scapulopexy (eg, sprengels deformity or for paralysis)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24615","name":"Optx aqt/chrnc elbow dislc","description":"Open treatment of acute or chronic elbow dislocation","date_of_service":"2026-05-10","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":"22830","name":"Exploration of spinal fusion","description":"Exploration of spinal fusion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":968.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1142.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"77332","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; simple (simple block, simple bolus)","date_of_service":"2026-05-10","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":"82379","name":"Assay of carnitine","description":"Carnitine (total and free), quantitative, each specimen","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1087.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55040","name":"Removal of hydrocele","description":"Excision of hydrocele; unilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95933","name":"Blink reflex test","description":"Orbicularis oculi (blink) reflex, by electrodiagnostic testing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"20970","name":"Bone/skin graft iliac crest","description":"Free osteocutaneous flap with microvascular anastomosis; iliac crest","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75555","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":682.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-10","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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0212T","name":"Compre audiometry evaluation","description":"Comprehensive audiometry threshold evaluation and speech recognition (0209t, 0211t combined), automated","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"50380","name":"Rnl autotrnsplj rimpltj kdn","description":"Renal autotransplantation, reimplantation of kidney","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"31400","name":"Revision of larynx","description":"Arytenoidectomy or arytenoidopexy, external approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1131.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"53665","name":"Dilation of urethra","description":"Dilation of female urethra, general or conduction (spinal) anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"78010","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35800","name":"Explore neck vessels","description":"Exploration for postoperative hemorrhage, thrombosis or infection; neck","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44382","name":"Small bowel endoscopy","description":"Ileoscopy, through stoma; with biopsy, single or multiple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42400","name":"Biopsy of salivary gland","description":"Biopsy of salivary gland; needle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1921.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"86890","name":"Autologous blood process","description":"Autologous blood or component, collection processing and storage; predeposited","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88140","name":"Sex chromatin identification","description":"Sex chromatin identification; peripheral blood smear, polymorphonuclear drumsticks","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2461.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5613","name":"Ak 4 bar ling w/hydraul swig","description":"Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":644.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95861","name":"Needle emg 2 extremities","description":"Needle electromyography; 2 extremities with or without related paraspinal areas","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45307","name":"Proctosigmoidoscopy fb","description":"Proctosigmoidoscopy, rigid; with removal of foreign body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78469","name":"Heart infarct image (3d)","description":"Myocardial imaging, infarct avid, planar; tomographic spect with or without quantification","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85220","name":"Blooc clot factor v test","description":"Clotting; factor v (acg or proaccelerin), labile factor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"90824","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00864","name":"Anes xtrprt lwr abd tot cstc","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; total cystectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78012","name":"Thyroid uptake measurement","description":"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)","date_of_service":"2026-05-10","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":"95955","name":"Eeg during surgery","description":"Electroencephalogram (eeg) during nonintracranial surgery (eg, carotid surgery)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0291","name":"Hosp bed fx ht w/o rail w/o","description":"Hospital bed, fixed height, without side rails, without mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26418","name":"Repair finger tendon","description":"Repair, extensor tendon, finger, primary or secondary; without free graft, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":635.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","date_of_service":"2026-05-10","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":"29720","name":"Repair spica body cst/jacket","description":"Repair of spica, body cast or jacket","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88106","name":"Cytopath fl nongyn filter","description":"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation","date_of_service":"2026-05-10","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":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":783.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2550","name":"Promethazine hcl injection","description":"Injection, promethazine hcl, up to 50 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","date_of_service":"2026-05-10","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":"61760","name":"Implant brain electrodes","description":"Stereotactic implantation of depth electrodes into the cerebrum for long-term seizure monitoring","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"73090","name":"X-ray exam of forearm","description":"Radiologic examination; forearm, 2 views","date_of_service":"2026-05-10","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":"96151","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1152.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1781.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"92516","name":"Facial nerve function test","description":"Facial nerve function studies (eg, electroneuronography)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35671","name":"Bpg pop-tibl/-prnl artery","description":"Bypass graft, with other than vein; popliteal-tibial or -peroneal artery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42800","name":"Biopsy of throat","description":"Biopsy; oropharynx","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-10","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":"85027","name":"Complete cbc automated","description":"Blood count; complete (cbc), automated (hgb, hct, rbc, wbc and platelet count)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2343","name":"W/c dpth 22-25 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"Q0168","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2342","name":"W/c dpth 20-21 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 20 or 21 inches","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3905","name":"Who w/nontorsion jnt(s) cf","description":"Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"99145","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"52300","name":"Cystoscopy and treatment","description":"Cystourethroscopy; with resection or fulguration of orthotopic ureterocele(s), unilateral or bilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"36430","name":"Transfusion bld/bld compnt","description":"Transfusion, blood or blood components","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90690","name":"Typhoid vaccine oral","description":"Typhoid vaccine, live, oral","date_of_service":"2026-05-10","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":133.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0325","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"35531","name":"Art byp grft aorcel/aormesen","description":"Bypass graft, with vein; aortoceliac or aortomesenteric","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2486.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"34800","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3418.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1021.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"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":"2026-05-10","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":"72220","name":"X-ray exam sacrum tailbone","description":"Radiologic examination, sacrum and coccyx, minimum of 2 views","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"L1690","name":"Combination bilateral ho","description":"Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"82491","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"78258","name":"Esophageal motility","description":"Esophageal motility","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"23130","name":"Acromp/acromionectomy prtl","description":"Acromioplasty or acromionectomy, partial, with or without coracoacromial ligament release","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00906","name":"Anes vulvectomy","description":"Anesthesia for; vulvectomy","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82978","name":"Assay of glutathione","description":"Glutathione","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0560","name":"Humidifier supplemental w/ i","description":"Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":530.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","date_of_service":"2026-05-10","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":"77063","name":"Breast tomosynthesis bi","description":"Screening digital breast tomosynthesis, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4213","name":"20+ cc syringe only","description":"Syringe, sterile, 20 cc or greater, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"V2304","name":"Lens sphcy trifocal 4.0/2.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 2.25-4.00d cylinder, per lens","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93965","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3730","name":"Forearm/arm cuffs ext/flex a","description":"Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2004.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00848","name":"Anes iper px pel exentration","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; pelvic exenteration","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32550","name":"Insert pleural cath","description":"Insertion of indwelling tunneled pleural catheter with cuff","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01622","name":"Anes dx arthr px shoulder jt","description":"Anesthesia for diagnostic arthroscopic procedures of shoulder joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6452","name":"High compres band w>=3in<5inyd","description":"High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83891","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"15301","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"C1876","name":"Stent, non-coa/non-cov w/del","description":"Stent, non-coated/non-covered, with delivery system","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"64644","name":"Chemodenerv 1 extrem 5/> mus","description":"Chemodenervation of one extremity; 5 or more muscles","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":608.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":426.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"62200","name":"Establish brain cavity shunt","description":"Ventriculocisternostomy, third ventricle;","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29819","name":"Sho arthrs srg rmvl loose/fb","description":"Arthroscopy, shoulder, surgical; with removal of loose body or foreign body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.16,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3695.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-10","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":"77057","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00211","name":"Anes icr px crnec/crnot hmtm","description":"Anesthesia for intracranial procedures; craniotomy or craniectomy for evacuation of hematoma","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1910.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"83876","name":"Assay myeloperoxidase","description":"Myeloperoxidase (mpo)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":701.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["AW"]}],"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":"2026-05-10","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":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-05-10","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":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97532","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50610","name":"Removal of ureter stone","description":"Ureterolithotomy; upper one-third of ureter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1205","name":"Chlorothiazide sodium inj","description":"Injection, chlorothiazide sodium, per 500 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32658","name":"Thoracoscopy w/sac fb remove","description":"Thoracoscopy, surgical; with removal of clot or foreign body from pericardial sac","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6234","name":"Hydrocolld drg <=16 w/o bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-10","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":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79300","name":"Nuclr rx interstit colloid","description":"Radiopharmaceutical therapy, by interstitial radioactive colloid administration","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46221","name":"Ligation of hemorrhoid(s)","description":"Hemorrhoidectomy, internal, by rubber band ligation(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26910","name":"Amputate metacarpal bone","description":"Amputation, metacarpal, with finger or thumb (ray amputation), single, with or without interosseous transfer","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26110","name":"Biopsy finger joint lining","description":"Arthrotomy with biopsy; interphalangeal joint, each","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"88355","name":"M/phmtrc alys skeletal musc","description":"Morphometric analysis; skeletal muscle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53025","name":"Incision of urethra","description":"Meatotomy, cutting of meatus (separate procedure); infant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33300","name":"Repair of heart wound","description":"Repair of cardiac wound; without bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.38,"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":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80201","name":"Assay of topiramate","description":"Topiramate","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"83090","name":"Assay of homocysteine","description":"Homocysteine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21150","name":"Rcnstj mdfc lefrtii ant ntru","description":"Reconstruction midface, lefort ii; anterior intrusion (eg, treacher-collins syndrome)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1987.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70491","name":"Ct soft tissue neck w/dye","description":"Computed tomography, soft tissue neck; with contrast material(s)","date_of_service":"2026-05-10","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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93561","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"43634","name":"Removal of stomach partial","description":"Gastrectomy, partial, distal; with formation of intestinal pouch","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1714.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27125","name":"Partial hip replacement","description":"Hemiarthroplasty, hip, partial (eg, femoral stem prosthesis, bipolar arthroplasty)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69910","name":"Remove inner ear & mastoid","description":"Labyrinthectomy; with mastoidectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"A6443","name":"Conform band n/s w>=3in<5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-10","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":"L2526","name":"Th/wght bear nar m-l brim cu","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"J3396","name":"Verteporfin injection","description":"Injection, verteporfin, 0.1 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90805","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"L5580","name":"Prep ak ischial thermo mold","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"J1450","name":"Fluconazole","description":"Injection fluconazole, 200 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"84436","name":"Assay of total thyroxine","description":"Thyroxine; total","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"25315","name":"Revise palsy hand tendon(s)","description":"Flexor origin slide (eg, for cerebral palsy, volkmann contracture), forearm and/or wrist;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84379","name":"Sugars multiple quant","description":"Sugars (mono-, di-, and oligosaccharides); multiple quantitative, each specimen","date_of_service":"2026-05-10","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":"86215","name":"Deoxyribonuclease antibody","description":"Deoxyribonuclease, antibody","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1063.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1293.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86880","name":"Coombs test direct","description":"Antihuman globulin test (coombs test); direct, each antiserum","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4211","name":"Supp for self-adm injections","description":"Supplies for self-administered injections","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2343","name":"W/c dpth 22-25 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2591.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74263","name":"Ct colonography screening","description":"Computed tomographic (ct) colonography, screening, including image postprocessing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"78457","name":"Venous thrombosis imaging","description":"Venous thrombosis imaging, venogram; unilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":506.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"G6001","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"93539","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"95973","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93304","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study","date_of_service":"2026-05-10","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":"L0150","name":"Cerv semi-rig adj molded chn","description":"Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibular/occipital piece)","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6700","name":"Ue add ext power myoel","description":"Upper extremity addition, external powered feature, myoelectronic control module, additional emg inputs, pattern-recognition decoding intent movement","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95861","name":"Needle emg 2 extremities","description":"Needle electromyography; 2 extremities with or without related paraspinal areas","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00216","name":"Anes icr px vascular px","description":"Anesthesia for intracranial procedures; vascular procedures","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92025","name":"Cptrized corneal topography","description":"Computerized corneal topography, unilateral or bilateral, with interpretation and report","date_of_service":"2026-05-10","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":"83864","name":"Mucopolysaccharides","description":"Mucopolysaccharides, acid, quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15351","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":"58570","name":"Tlh uterus 250 g or less","description":"Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less;","date_of_service":"2026-05-10","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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0070","name":"Rr whl compl pne tire rep ea","description":"Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each","date_of_service":"2026-05-10","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":"32650","name":"Thoracoscopy w/pleurodesis","description":"Thoracoscopy, surgical; with pleurodesis (eg, mechanical or chemical)","date_of_service":"2026-05-10","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":"82746","name":"Assay of folic acid serum","description":"Folic acid; serum","date_of_service":"2026-05-10","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":"73120","name":"X-ray exam of hand","description":"Radiologic examination, hand; 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"93970","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study","date_of_service":"2026-05-10","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":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":711.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75957","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6223","name":"Gauze >16<=48 no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"55040","name":"Removal of hydrocele","description":"Excision of hydrocele; unilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0346","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2128","name":"Kafo fem fx cast molded to p","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84392","name":"Assay of urine sulfate","description":"Sulfate, urine","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":728.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A5057","name":"1 pc ost pou w built-in conv","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0602","name":"Repl batt silver oxide 3 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L3160","name":"Shoe styled positioning dev","description":"Foot, adjustable shoe-styled positioning device","date_of_service":"2026-05-10","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":"23350","name":"Injection for shoulder x-ray","description":"Injection procedure for shoulder arthrography or enhanced ct/mri shoulder arthrography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01852","name":"Anes px vn f/arm phlbrrhaphy","description":"Anesthesia for procedures on veins of forearm, wrist, and hand; phleborrhaphy","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21084","name":"Impres&prep sp aid prosth","description":"Impression and custom preparation; speech aid prosthesis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1903.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2708.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86688","name":"Htlv-ii antibody","description":"Antibody; htlv-ii","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"P9041","name":"Albumin (human),5%, 50ml","description":"Infusion, albumin (human), 5%, 50 ml","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"45332","name":"Sigmoidoscopy w/fb removal","description":"Sigmoidoscopy, flexible; with removal of foreign body(s)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01180","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79005","name":"Nuclear rx oral admin","description":"Radiopharmaceutical therapy, by oral administration","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","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":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L0172","name":"Cerv col sr foam 2pc pre ots","description":"Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0106","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"L0470","name":"Tlso rigid frame pre subclav","description":"Tlso, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction to scapula, lateral strength provided by pelvic, thoracic, and lateral frame pieces, rotational strength provided by subclavicular extensions, restr","date_of_service":"2026-05-10","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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74710","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1132.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70355","name":"Panoramic x-ray of jaws","description":"Orthopantogram (eg, panoramic x-ray)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"43500","name":"Surgical opening of stomach","description":"Gastrotomy; with exploration or foreign body removal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54840","name":"Remove epididymis lesion","description":"Excision of spermatocele, with or without epididymectomy","date_of_service":"2026-05-10","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":"E0610","name":"Pacemaker monitr audible/vis","description":"Pacemaker monitor, self-contained, (checks battery depletion, includes audible and visible check systems)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74710","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["AU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90649","name":"4vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 6, 11, 16, 18, quadrivalent (4vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"82190","name":"Atomic absorption","description":"Atomic absorption spectroscopy, each analyte","date_of_service":"2026-05-10","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":"J9094","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"77421","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28510","name":"Treatment of toe fracture","description":"Closed treatment of fracture, phalanx or phalanges, other than great toe; without manipulation, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"45402","name":"Lap proctopexy w/sig resect","description":"Laparoscopy, surgical; proctopexy (for prolapse), with sigmoid resection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37230","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69552","name":"Exc aurl glomus tum trnsmstd","description":"Excision aural glomus tumor; transmastoid","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1878.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"27724","name":"Repair/graft of tibia","description":"Repair of nonunion or malunion, tibia; with iliac or other autograft (includes obtaining graft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","date_of_service":"2026-05-10","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":"00102","name":"Anes px plstc rpr cleft lip","description":"Anesthesia for procedures involving plastic repair of cleft lip","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"31500","name":"Insert emergency airway","description":"Intubation, endotracheal, emergency procedure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"78660","name":"Nuclear exam of tear flow","description":"Radiopharmaceutical dacryocystography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77787","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"L3919","name":"Ho w/o joints cf","description":"Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1031","name":"Rollabout chair with casters","description":"Rollabout chair, any and all types with casters 5 or greater","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34051","name":"Removal of artery clot","description":"Embolectomy or thrombectomy, with or without catheter; innominate, subclavian artery, by thoracic incision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1130.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-10","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":"01782","name":"Anes vn upr arm&elbw phlbrpy","description":"Anesthesia for procedures on veins of upper arm and elbow; phleborrhaphy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1639.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1237.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00142","name":"Anes px on eye lens surgery","description":"Anesthesia for procedures on eye; lens surgery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","date_of_service":"2026-05-10","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":"93541","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"42107","name":"Excision lesion mouth roof","description":"Excision, lesion of palate, uvula; with local flap closure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2330","name":"Lacer molded to patient mode","description":"Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27001","name":"Tenotomy adductor hip open","description":"Tenotomy, adductor of hip, open","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":653.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59001","name":"Amniocentesis therapeutic","description":"Amniocentesis; therapeutic amniotic fluid reduction (includes ultrasound guidance)","date_of_service":"2026-05-10","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":"49611","name":"Repair umbilical lesion","description":"Repair of omphalocele (gross type operation); second stage","date_of_service":"2026-05-10","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":"43272","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"63180","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1524.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"69667","name":"Repair middle ear structures","description":"Repair round window fistula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":651.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":632.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26706","name":"Pin knuckle dislocation","description":"Percutaneous skeletal fixation of metacarpophalangeal dislocation, single, with manipulation","date_of_service":"2026-05-10","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":"27412","name":"Autochondrocyte implant knee","description":"Autologous chondrocyte implantation, knee","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1398.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7070","name":"D5w infusion","description":"Infusion, d5w, 1000 cc","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"75964","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"29435","name":"Appl patllr tdn bearing cast","description":"Application of patellar tendon bearing (ptb) cast","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"78216","name":"Lvr&spleen img w/vasc flow","description":"Liver and spleen imaging; with vascular flow","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65430","name":"Corneal smear","description":"Scraping of cornea, diagnostic, for smear and/or culture","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"21627","name":"Sternal debridement","description":"Sternal debridement","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86789","name":"West nile virus antibody","description":"Antibody; west nile virus","date_of_service":"2026-05-10","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":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"J2210","name":"Methylergonovin maleate inj","description":"Injection, methylergonovine maleate, up to 0.2 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88233","name":"Tissue culture skin/biopsy","description":"Tissue culture for non-neoplastic disorders; skin or other solid tissue biopsy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66840","name":"Removal of lens material","description":"Removal of lens material; aspiration technique, 1 or more stages","date_of_service":"2026-05-10","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":"50920","name":"Closure ureter/skin fistula","description":"Closure of ureterocutaneous fistula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28345","name":"Repair webbed toe(s)","description":"Reconstruction, toe(s); syndactyly, with or without skin graft(s), each web","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0622","name":"Sio flex pelvisacral custom","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78190","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8515","name":"Cabergoline, oral 0.25mg","description":"Cabergoline, oral, 0.25 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J1790","name":"Droperidol injection","description":"Injection, droperidol, up to 5 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"11101","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-10","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":"33800","name":"Aortic suspension","description":"Aortic suspension (aortopexy) for tracheal decompression (eg, for tracheomalacia) (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62121","name":"Incise skull repair","description":"Craniotomy for repair of encephalocele, skull base","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1338.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","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":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1286.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","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":"2026-05-10","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":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":528.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2909.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88319","name":"Enzyme histochemistry","description":"Special stain including interpretation and report; group iii, for enzyme constituents","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53235","name":"Removal of urethra lesion","description":"Excision of urethral diverticulum (separate procedure); male","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78584","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3670","name":"So acro/clav can web pre ots","description":"Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"86723","name":"Listeria monocytogenes","description":"Antibody; listeria monocytogenes","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-10","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":"71100","name":"X-ray exam ribs uni 2 views","description":"Radiologic examination, ribs, unilateral; 2 views","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00620","name":"Anes px thrc spine&cord nos","description":"Anesthesia for procedures on thoracic spine and cord, not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"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":"90471","name":"Immunization admin","description":"Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections); 1 vaccine (single or combination vaccine/toxoid)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"39000","name":"Exploration of chest","description":"Mediastinotomy with exploration, drainage, removal of foreign body, or biopsy; cervical approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"24363","name":"Replace elbow joint","description":"Arthroplasty, elbow; with distal humerus and proximal ulnar prosthetic replacement (eg, total elbow)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84260","name":"Assay of serotonin","description":"Serotonin","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":882.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6590","name":"Shdr fair lead cable direct","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"39220","name":"Resect mediastinal tumor","description":"Resection of mediastinal tumor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":977.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82731","name":"Assay of fetal fibronectin","description":"Fetal fibronectin, cervicovaginal secretions, semi-quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4389","name":"Drainable pch w st wear barr","description":"Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92984","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86687","name":"Htlv-i antibody","description":"Antibody; htlv-i","date_of_service":"2026-05-10","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":"75790","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"G0393","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72125","name":"Ct neck spine w/o dye","description":"Computed tomography, cervical spine; without contrast material","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","date_of_service":"2026-05-10","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":"86335","name":"Immunfix e-phorsis/urine/csf","description":"Immunofixation electrophoresis; other fluids with concentration (eg, urine, csf)","date_of_service":"2026-05-10","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":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":604.76,"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":"99188","name":"App topical fluoride varnish","description":"Application of topical fluoride varnish by a physician or other qualified health care professional","date_of_service":"2026-05-10","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":"74410","name":"Urography nfs drip&/bolus","description":"Urography, infusion, drip technique and/or bolus technique;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1837.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80198","name":"Assay of theophylline","description":"Theophylline","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"11765","name":"Wedge excision skn nail fold","description":"Wedge excision of skin of nail fold (eg, for ingrown toenail)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31780","name":"Reconstruct windpipe","description":"Excision tracheal stenosis and anastomosis; cervical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1352.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"46900","name":"Destruction anal lesion(s)","description":"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; chemical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1388.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"27041","name":"Biopsy of soft tissues","description":"Biopsy, soft tissue of pelvis and hip area; deep, subfascial or intramuscular","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57400","name":"Dilation of vagina","description":"Dilation of vagina under anesthesia (other than local)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"99363","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"42665","name":"Ligation of salivary duct","description":"Ligation salivary duct, intraoral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0638","name":"Lso sag-coronal panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"83036","name":"Hemoglobin glycosylated a1c","description":"Hemoglobin; glycosylated (a1c)","date_of_service":"2026-05-10","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":"19125","name":"Excision breast lesion","description":"Excision of breast lesion identified by preoperative placement of radiological marker, open; single lesion","date_of_service":"2026-05-10","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":"93581","name":"Transcath closure of vsd","description":"Percutaneous transcatheter closure of a congenital ventricular septal defect with implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1544.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3660","name":"So 8 ab rstr can/web pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"21347","name":"Opn tx nasomax fx multple","description":"Open treatment of nasomaxillary complex fracture (lefort ii type); requiring multiple open approaches","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2310","name":"Lens sphc trifocal 4.25-7/>6","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86160","name":"Complement antigen","description":"Complement; antigen, each component","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"E0571","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"93930","name":"Upper extremity study","description":"Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study","date_of_service":"2026-05-10","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":"29365","name":"Appl cylinder cast","description":"Application of cylinder cast (thigh to ankle)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01962","name":"Anes urgent hysterectomy","description":"Anesthesia for urgent hysterectomy following delivery","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":747.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2211","name":"Lens sphcy bifo 7.25-12/.25-","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"94772","name":"Circadian respir pattern rec","description":"Circadian respiratory pattern recording (pediatric pneumogram), 12-24 hour continuous recording, infant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6236","name":"Hydrocolld drg > 48 in w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3905","name":"Who w/nontorsion jnt(s) cf","description":"Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1260","name":"Dolasetron mesylate","description":"Injection, dolasetron mesylate, 10 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29058","name":"Appl cast plaster velpeau","description":"Application, cast; plaster velpeau","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"19110","name":"Nipple exploration","description":"Nipple exploration, with or without excision of a solitary lactiferous duct or a papilloma lactiferous duct","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19240","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1177.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75880","name":"Vein x-ray eye socket","description":"Venography, orbital, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":"A6210","name":"Foam drg >16<=48 sq in w/o b","description":"Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"87101","name":"Skin fungi culture","description":"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; skin, hair, or nail","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2106","name":"Afo tib fx cast plaster mold","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"52647","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6204","name":"Composite drsg >16<=48 sq in","description":"Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":510.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"78070","name":"Parathyroid planar imaging","description":"Parathyroid planar imaging (including subtraction, when performed);","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90707","name":"Mmr vaccine sc","description":"Measles, mumps and rubella virus vaccine (mmr), live, for subcutaneous use","date_of_service":"2026-05-10","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":111.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":883.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1799.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":653.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1543.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77326","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":683.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99331","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0484","name":"Tlso rigid plastic cust fab","description":"Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by ov","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":886.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"J1060","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00790","name":"Anes iper upr abd nos","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4351","name":"Straight tip urine catheter","description":"Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3999","name":"Upper limb orthosis nos","description":"Upper limb orthosis, not otherwise specified","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62291","name":"Njx px discography crv/thrc","description":"Injection procedure for discography, each level; cervical or thoracic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"61542","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70460","name":"Ct head/brain w/dye","description":"Computed tomography, head or brain; with contrast material(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72050","name":"X-ray exam neck spine 4/5vws","description":"Radiologic examination, spine, cervical; 4 or 5 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0280","name":"Aminophyllin 250 mg inj","description":"Injection, aminophyllin, up to 250 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76818","name":"Fetal biophys profile w/nst","description":"Fetal biophysical profile; with non-stress testing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25112","name":"Reremove wrist tendon lesion","description":"Excision of ganglion, wrist (dorsal or volar); recurrent","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":896.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01622","name":"Anes dx arthr px shoulder jt","description":"Anesthesia for diagnostic arthroscopic procedures of shoulder joint","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2208","name":"Lens sphcy bifocal 4.25-7/2.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1219.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"84600","name":"Assay of volatiles","description":"Volatiles (eg, acetic anhydride, diethylether)","date_of_service":"2026-05-10","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":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33975","name":"Implant ventricular device","description":"Insertion of ventricular assist device; extracorporeal, single ventricle","date_of_service":"2026-05-10","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":"73080","name":"X-ray exam of elbow","description":"Radiologic examination, elbow; complete, minimum of 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3077.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-10","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":"37650","name":"Ligation of femoral vein","description":"Ligation of femoral vein","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3463.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7506","name":"Hmes/trachvalve adhesivedisk","description":"Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":674.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35642","name":"Bpg carotid-vertebral","description":"Bypass graft, with other than vein; carotid-vertebral","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1861.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":842.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27306","name":"Incision of thigh tendon","description":"Tenotomy, percutaneous, adductor or hamstring; single tendon (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":467.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86386","name":"Nuclear matrix protein 22","description":"Nuclear matrix protein 22 (nmp22), qualitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"51725","name":"Simple cystometrogram","description":"Simple cystometrogram (cmg) (eg, spinal manometer)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7046","name":"Repl water chamber, pap dev","description":"Water chamber for humidifier, used with positive airway pressure device, replacement, each","date_of_service":"2026-05-10","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":"P9046","name":"Albumin (human), 25%, 20 ml","description":"Infusion, albumin (human), 25%, 20 ml","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74021","name":"Radex abdomen 3+ views","description":"Radiologic examination, abdomen; 3 or more views","date_of_service":"2026-05-10","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":"64622","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":813.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33692","name":"Comp rpr tof wo pulm atresia","description":"Complete repair tetralogy of fallot without pulmonary atresia;","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"55175","name":"Revision of scrotum","description":"Scrotoplasty; simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27265","name":"Treat hip dislocation","description":"Closed treatment of post hip arthroplasty dislocation; without anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1050","name":"Whelchr fxd full length arms","description":"Fully-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","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":"84410","name":"Testosterone bioavailable","description":"Testosterone; bioavailable, direct measurement (eg, differential precipitation)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2059.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","date_of_service":"2026-05-10","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":"97026","name":"Infrared therapy","description":"Application of a modality to 1 or more areas; infrared","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"35661","name":"Bpg femoral-femoral","description":"Bypass graft, with other than vein; femoral-femoral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1369.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36500","name":"Insertion of catheter vein","description":"Venous catheterization for selective organ blood sampling","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"54152","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2192","name":"Pelvic band & belt thigh fla","description":"Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"11981","name":"Insertion drug dlvr implant","description":"Insertion, drug-delivery implant (ie, bioresorbable, biodegradable, non-biodegradable)","date_of_service":"2026-05-10","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":"19370","name":"Revj peri-implt capsule brst","description":"Revision of peri-implant capsule, breast, including capsulotomy, capsulorrhaphy, and/or partial capsulectomy","date_of_service":"2026-05-10","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":"90746","name":"Hepb vaccine 3 dose adult im","description":"Hepatitis b vaccine (hepb), adult dosage, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","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":82.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28116","name":"Revision of foot","description":"Ostectomy, excision of tarsal coalition","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":629.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31582","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0628","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74360","name":"X-ray guide gi dilation","description":"Intraluminal dilation of strictures and/or obstructions (eg, esophagus), radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59426","name":"Antepartum care only","description":"Antepartum care only; 7 or more visits","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"16010","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":644.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"33401","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"82043","name":"Ur albumin quantitative","description":"Albumin; urine (eg, microalbumin), quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21079","name":"Impres&prep intrm obt prosth","description":"Impression and custom preparation; interim obturator prosthesis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1925.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"0013A","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KM"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78813","name":"Pet image full body","description":"Positron emission tomography (pet) imaging; whole body","date_of_service":"2026-05-10","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":"86005","name":"Allg spec ige multiallg scr","description":"Allergen specific ige; qualitative, multiallergen screen (eg, disk, sponge, card)","date_of_service":"2026-05-10","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":"L3968","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1327.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76872","name":"Us transrectal","description":"Ultrasound, transrectal;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0342","name":"Laparoscopy islet cell trans","description":"Laparoscopy for islet cell transplant, includes portal vein catheterization and infusion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1380","name":"Estradiol valerate 10 mg inj","description":"Injection, estradiol valerate, up to 10 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1709.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57065","name":"Destruction vag lesion xtnsv","description":"Destruction of vaginal lesion(s); extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-10","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":"90670","name":"Pcv13 vaccine im","description":"Pneumococcal conjugate vaccine, 13 valent (pcv13), for intramuscular use","date_of_service":"2026-05-10","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":257.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1335.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1232","name":"Folding ped wc tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"27590","name":"Amputate leg at thigh","description":"Amputation, thigh, through femur, any level;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":689.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72020","name":"X-ray exam of spine 1 view","description":"Radiologic examination, spine, single view, specify level","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"L3968","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","date_of_service":"2026-05-10","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":"20969","name":"Bone/skin graft microvasc","description":"Free osteocutaneous flap with microvascular anastomosis; other than iliac crest, metatarsal, or great toe","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3367.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KF"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70355","name":"Panoramic x-ray of jaws","description":"Orthopantogram (eg, panoramic x-ray)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1270","name":"Wheelchair lightweight leg r","description":"Lightweight wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"43330","name":"Esophagomyotomy abdominal","description":"Esophagomyotomy (heller type); abdominal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1119.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"90396","name":"Varicella-zoster ig im","description":"Varicella-zoster immune globulin, human, for intramuscular use","date_of_service":"2026-05-10","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":2756.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01842","name":"Anes art farm wrst&hnd emblc","description":"Anesthesia for procedures on arteries of forearm, wrist, and hand; embolectomy","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86648","name":"Diphtheria antibody","description":"Antibody; diphtheria","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0488","name":"Tlso rigid lined pre one pie","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5822","name":"Endo knee-shin pneum swg frc","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00210","name":"Anes intracranial px nos","description":"Anesthesia for intracranial procedures; not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2207","name":"Lens sphcy bifocal 4.25-7d/.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"Q0497","name":"Bat clps elec/comb vad, rep","description":"Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5695","name":"Ak sleeve susp neoprene/equa","description":"Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21386","name":"Opn tx orbit fx periorbital","description":"Open treatment of orbital floor blowout fracture; periorbital approach","date_of_service":"2026-05-10","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":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":828.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1821","name":"Replacement interface spsd","description":"Replacement soft interface material/cuffs for bi-directional static progressive stretch device","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6711","name":"Ped term dev, hook, vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9957","name":"Inj perflutren lip micros,ml","description":"Injection, perflutren lipid microspheres, per ml","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6711","name":"Ped term dev, hook, vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"64420","name":"Njx aa&/strd ntrcost nrv 1","description":"Injection(s), anesthetic agent(s) and/or steroid; intercostal nerve, single level","date_of_service":"2026-05-10","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":"36680","name":"Insert needle bone cavity","description":"Placement of needle for intraosseous infusion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8509","name":"Trach-esoph voice pros md in","description":"Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"54550","name":"Exploration for testis","description":"Exploration for undescended testis (inguinal or scrotal area)","date_of_service":"2026-05-10","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":"72292","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","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":"L1630","name":"Abduct control hip semi-flex","description":"Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","date_of_service":"2026-05-10","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":"91105","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"62121","name":"Incise skull repair","description":"Craniotomy for repair of encephalocele, skull base","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1882.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","date_of_service":"2026-05-10","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":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6223","name":"Gauze >16<=48 no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"38308","name":"Incision of lymph channels","description":"Lymphangiotomy or other operations on lymphatic channels","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0360","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"61609","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62220","name":"Establish brain cavity shunt","description":"Creation of shunt; ventriculo-atrial, -jugular, -auricular","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6384","name":"Postop dsg cast chg shlder/t","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1656.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"43832","name":"Gstrst open w/constj tube","description":"Gastrostomy, open; with construction of gastric tube (eg, janeway procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2496.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93505","name":"Endomyocardial biopsy","description":"Endomyocardial biopsy","date_of_service":"2026-05-10","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":"67500","name":"Inject/treat eye socket","description":"Retrobulbar injection; medication (separate procedure, does not include supply of medication)","date_of_service":"2026-05-10","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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":648.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86784","name":"Trichinella antibody","description":"Antibody; trichinella","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","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":"2026-05-10","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":"27641","name":"Partial removal of fibula","description":"Partial excision (craterization, saucerization, or diaphysectomy), bone (eg, osteomyelitis); fibula","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"72120","name":"X-ray bend only l-s spine","description":"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"88125","name":"Forensic cytopathology","description":"Cytopathology, forensic (eg, sperm)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"01852","name":"Anes px vn f/arm phlbrrhaphy","description":"Anesthesia for procedures on veins of forearm, wrist, and hand; phleborrhaphy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"E0628","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"33786","name":"Repair arterial trunk","description":"Total repair, truncus arteriosus (rastelli type operation)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"J9360","name":"Vinblastine sulfate inj","description":"Injection, vinblastine sulfate, 1 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3136.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78478","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":645.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"0501T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15945","name":"Exc isch pr ulc skn flp ostc","description":"Excision, ischial pressure ulcer, with skin flap closure; with ostectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1092.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"15822","name":"Blepharoplasty upper eyelid","description":"Blepharoplasty, upper eyelid;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1222.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86762","name":"Rubella antibody","description":"Antibody; rubella","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68325","name":"Revise/graft eyelid lining","description":"Conjunctivoplasty; with buccal mucous membrane graft (includes obtaining graft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":638.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1704.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00145","name":"Anes px eye vitreortnl surg","description":"Anesthesia for procedures on eye; vitreoretinal surgery","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1620","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1960.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"23170","name":"Sequestrectomy clavicle","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), clavicle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69424","name":"Remove ventilating tube","description":"Ventilating tube removal requiring general anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3674","name":"So airplane w/wo joint cf","description":"Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"32402","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1651.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"36470","name":"Njx sclrsnt 1 incmptnt vein","description":"Injection of sclerosant; single incompetent vein (other than telangiectasia)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36832","name":"Av fistula revision open","description":"Revision, open, arteriovenous fistula; without thrombectomy, autogenous or nonautogenous dialysis graft (separate procedure)","date_of_service":"2026-05-10","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":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31086","name":"Removal of frontal sinus","description":"Sinusotomy frontal; nonobliterative, with osteoplastic flap, brow incision","date_of_service":"2026-05-10","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":"95910","name":"Nrv cndj test 7-8 studies","description":"Nerve conduction studies; 7-8 studies","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0700","name":"Ctlso a-p-l control molded","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"25350","name":"Revision of radius","description":"Osteotomy, radius; distal third","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90389","name":"Tetanus ig im","description":"Tetanus immune globulin (tig), human, for intramuscular use","date_of_service":"2026-05-10","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":747.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1401.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"50947","name":"Laparo new ureter/bladder","description":"Laparoscopy, surgical; ureteroneocystostomy with cystoscopy and ureteral stent placement","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1591.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":993.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"0208T","name":"Audiometry air only","description":"Pure tone audiometry (threshold), automated; air only","date_of_service":"2026-05-10","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":"52402","name":"Cysto trurl rescj ejacul dux","description":"Cystourethroscopy with transurethral resection or incision of ejaculatory ducts","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"83904","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"86940","name":"Hemolysins/agglutinins auto","description":"Hemolysins and agglutinins; auto, screen, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"96119","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84630","name":"Assay of zinc","description":"Zinc","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":840.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36821","name":"Av fusion direct any site","description":"Arteriovenous anastomosis, open; direct, any site (eg, cimino type) (separate procedure)","date_of_service":"2026-05-10","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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27175","name":"Treat slipped epiphysis","description":"Treatment of slipped femoral epiphysis; by traction, without reduction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":758.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"87621","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3264.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6197","name":"Alginate drsg >16 <=48 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37251","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5848","name":"Knee-shin sys hydraul stance","description":"Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability","date_of_service":"2026-05-10","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":"71023","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"74247","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1372","name":"Oxy suppl heater for nebuliz","description":"Immersion external heater for nebulizer","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2576.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"43310","name":"Repair of esophagus","description":"Esophagoplasty (plastic repair or reconstruction), thoracic approach; without repair of tracheoesophageal fistula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74425","name":"Urography antegrade rs&i","description":"Urography, antegrade, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","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":"2026-05-10","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":"E1160","name":"Wheelchair fixed arms","description":"Wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"92576","name":"Synthetic sentence id test","description":"Synthetic sentence identification test","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"28645","name":"Repair toe dislocation","description":"Open treatment of metatarsophalangeal joint dislocation, includes internal fixation, when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83721","name":"Assay of blood lipoprotein","description":"Lipoprotein, direct measurement; ldl cholesterol","date_of_service":"2026-05-10","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":"23221","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1478.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"0073T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"94150","name":"Vital capacity test","description":"Vital capacity, total (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95056","name":"Photo tests","description":"Photo tests","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31755","name":"Trachplsty trchphryngl fstlj","description":"Tracheoplasty; tracheopharyngeal fistulization, each stage","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1904.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"44800","name":"Excision of bowel pouch","description":"Excision of meckels diverticulum (diverticulectomy) or omphalomesenteric duct","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25040","name":"Arthrt rdcrpl/midcarpl jt","description":"Arthrotomy, radiocarpal or midcarpal joint, with exploration, drainage, or removal of foreign body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":714.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"84153","name":"Assay of psa total","description":"Prostate specific antigen (psa); total","date_of_service":"2026-05-10","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":"16035","name":"Escharotomy 1st incision","description":"Escharotomy; initial incision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"87530","name":"Hsv dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); herpes simplex virus, quantification","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00104","name":"Anes electroconvulsive ther","description":"Anesthesia for electroconvulsive therapy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":"63283","name":"Bx/exc idrl spine lesn scrl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, sacral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78660","name":"Nuclear exam of tear flow","description":"Radiopharmaceutical dacryocystography","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"57120","name":"Colpocleisis le fort type","description":"Colpocleisis (le fort type)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4657","name":"Syringe w/wo needle","description":"Syringe, with or without needle, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L1110","name":"Ring flange plas/leather mol","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0343","name":"Laparotomy islet cell transp","description":"Laparotomy for islet cell transplant, includes portal vein catheterization and infusion","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-05-10","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":"E1238","name":"Fld ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, folding, adjustable, without seating system","date_of_service":"2026-05-10","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":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00190","name":"Anes px facial b1/skull nos","description":"Anesthesia for procedures on facial bones or skull; not otherwise specified","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1227","name":"Wheelchair spec sz spec ht a","description":"Special height arms for wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6235","name":"Hydrocolld drg >16<=48 w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E1831","name":"Static str toe dev ext/flex","description":"Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00600","name":"Anes px crv spine&cord nos","description":"Anesthesia for procedures on cervical spine and cord; not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58275","name":"Hysterectomy/revise vagina","description":"Vaginal hysterectomy, with total or partial vaginectomy;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1130.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27786","name":"Treatment of ankle fracture","description":"Closed treatment of distal fibular fracture (lateral malleolus); without manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78600","name":"Brain image < 4 views","description":"Brain imaging, less than 4 static views;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0930","name":"Fracture frame free standing","description":"Fracture frame, free standing, includes weights","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76642","name":"Ultrasound breast limited","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83088","name":"Assay of histamine","description":"Histamine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7400","name":"Add ue prost be/wd, ultlite","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"68505","name":"Partial removal tear gland","description":"Excision of lacrimal gland (dacryoadenectomy), except for tumor; partial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":988.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"95824","name":"Eeg cerebral death only","description":"Electroencephalogram (eeg); cerebral death evaluation only","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2387","name":"Add le poly knee custom kafo","description":"Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"31075","name":"Exploration of frontal sinus","description":"Sinusotomy frontal; transorbital, unilateral (for mucocele or osteoma, lynch type)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J9098","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":477.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1650","name":"Ho abduction hip adjustable","description":"Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01382","name":"Anes dx arthrs px knee jt","description":"Anesthesia for diagnostic arthroscopic procedures of knee joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"32653","name":"Thoracoscopy remov fb/fibrin","description":"Thoracoscopy, surgical; with removal of intrapleural foreign body or fibrin deposit","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","AU","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B9006","name":"Parenteral infus pump statio","description":"Parenteral nutrition infusion pump, stationary","date_of_service":"2026-05-10","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":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","21","49","02","65","81","32","11","24","22","33","10","13","12","31"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76498","name":"Unlisted mr procedure","description":"Unlisted magnetic resonance procedure (eg, diagnostic, interventional)","date_of_service":"2026-05-10","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":"92611","name":"Motion fluoroscopy/swallow","description":"Motion fluoroscopic evaluation of swallowing function by cine or video recording","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90679","name":"Rsv vacc pref recomb adjt im","description":"Respiratory syncytial virus vaccine, pref, recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","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":349.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"43651","name":"Laparoscopy vagus nerve","description":"Laparoscopy, surgical; transection of vagus nerves, truncal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":725.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":850.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21127","name":"Augmentation mndblr b1 grf","description":"Augmentation, mandibular body or angle; with bone graft, onlay or interpositional (includes obtaining autograft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3259.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51600","name":"Injection for bladder x-ray","description":"Injection procedure for cystography or voiding urethrocystography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90671","name":"Pcv15 vaccine im","description":"Pneumococcal conjugate vaccine, 15 valent (pcv15), for intramuscular use","date_of_service":"2026-05-10","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":274.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0638","name":"Lso sag-coronal panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":641.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"68770","name":"Close tear system fistula","description":"Closure of lacrimal fistula (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15934","name":"Exc sacral pr ulc skn flap","description":"Excision, sacral pressure ulcer, with skin flap closure;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27132","name":"Total hip arthroplasty","description":"Conversion of previous hip surgery to total hip arthroplasty, with or without autograft or allograft","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"57513","name":"Laser surgery of cervix","description":"Cautery of cervix; laser ablation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6895","name":"Custom glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated","date_of_service":"2026-05-10","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":"69433","name":"Create eardrum opening","description":"Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84140","name":"Assay of pregnenolone","description":"Pregnenolone","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":"54670","name":"Repair testis injury","description":"Suture or repair of testicular injury","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"00851","name":"Anes iper px tubal ligation","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; tubal ligation/transection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"29898","name":"Ankle arthroscopy/surgery","description":"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, extensive","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":825.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1109.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78587","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1545.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29914","name":"Hip arthro w/femoroplasty","description":"Arthroscopy, hip, surgical; with femoroplasty (ie, treatment of cam lesion)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3730.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15734","name":"Muscle-skin graft trunk","description":"Muscle, myocutaneous, or fasciocutaneous flap; trunk","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":987.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25652","name":"Optx ulnar styloid fracture","description":"Open treatment of ulnar styloid fracture","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1138.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1951","name":"Afo spiral prefab custom","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1533.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":725.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":795.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"20520","name":"Rmvl fb musc/tdn simple","description":"Removal of foreign body in muscle or tendon sheath; simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","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":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","date_of_service":"2026-05-10","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":"76856","name":"Us exam pelvic complete","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31051","name":"Sphenoid sinus surgery","description":"Sinusotomy, sphenoid, with or without biopsy; with mucosal stripping or removal of polyp(s)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21495","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":663.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26842","name":"Thumb fusion with graft","description":"Arthrodesis, carpometacarpal joint, thumb, with or without internal fixation; with autograft (includes obtaining graft)","date_of_service":"2026-05-10","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":"86705","name":"Hep b core antibody igm","description":"Hepatitis b core antibody (hbcab); igm antibody","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78261","name":"Gastric mucosa imaging","description":"Gastric mucosa imaging","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"32854","name":"Lung transplant with bypass","description":"Lung transplant, double (bilateral sequential or en bloc); with cardiopulmonary bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8584.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"84252","name":"Assay of vitamin b-2","description":"Riboflavin (vitamin b-2)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"95819","name":"Eeg awake and asleep","description":"Electroencephalogram (eeg); including recording awake and asleep","date_of_service":"2026-05-10","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":"64763","name":"Incise hip/thigh nerve","description":"Transection or avulsion of obturator nerve, extrapelvic, with or without adductor tenotomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99322","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8625","name":"Charger coch impl/aoi battry","description":"External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"28222","name":"Release of foot tendons","description":"Tenolysis, flexor, foot; multiple tendons","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97139","name":"Unlisted therapeutic px","description":"Unlisted therapeutic procedure (specify)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21121","name":"Geniop sldg osteot 1","description":"Genioplasty; sliding osteotomy, single piece","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","date_of_service":"2026-05-10","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":"83840","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78605","name":"Brain image 4+ views","description":"Brain imaging, minimum 4 static views;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2760","name":"Extension per extension per","description":"Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75710","name":"Artery x-rays arm/leg","description":"Angiography, extremity, unilateral, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0353T","name":"Intraop oct breast cavity","description":"Optical coherence tomography of breast, surgical cavity; real-time intraoperative","date_of_service":"2026-05-10","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":"46705","name":"Repair of anal stricture","description":"Anoplasty, plastic operation for stricture; infant","date_of_service":"2026-05-10","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":"E0779","name":"Amb infusion pump mechanical","description":"Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2317.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1569.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"31725","name":"Clearance of airways","description":"Catheter aspiration (separate procedure); tracheobronchial with fiberscope, bedside","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"27560","name":"Treat kneecap dislocation","description":"Closed treatment of patellar dislocation; without anesthesia","date_of_service":"2026-05-10","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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52441","name":"Cysto insj trnsprstc 1 implt","description":"Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; single implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1099.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3921","name":"Hfo w/joint(s) cf","description":"Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82271","name":"Occult blood other sources","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources","date_of_service":"2026-05-10","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":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-10","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":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00530","name":"Anes perm transvns pm insj","description":"Anesthesia for permanent transvenous pacemaker insertion","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84207","name":"Assay of vitamin b-6","description":"Pyridoxal phosphate (vitamin b-6)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"96000","name":"Motion analysis video/3d","description":"Comprehensive computer-based motion analysis by video-taping and 3d kinematics;","date_of_service":"2026-05-10","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":"77047","name":"Mri breast c- bilateral","description":"Magnetic resonance imaging, breast, without contrast material; bilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29305","name":"Appl hip spica cast 1 leg","description":"Application of hip spica cast; 1 leg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6443","name":"Conform band n/s w>=3in<5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84402","name":"Assay of free testosterone","description":"Testosterone; free","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"22522","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"95958","name":"Eeg monitoring/function test","description":"Wada activation test for hemispheric function, including electroencephalographic (eeg) monitoring","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-05-10","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":"50380","name":"Rnl autotrnsplj rimpltj kdn","description":"Renal autotransplantation, reimplantation of kidney","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"78428","name":"Cardiac shunt imaging","description":"Cardiac shunt detection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26520","name":"Release knuckle contracture","description":"Capsulectomy or capsulotomy; metacarpophalangeal joint, each joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0204","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6584","name":"Elbow fair lead cable molded","description":"Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-10","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":"93770","name":"Determination venous press","description":"Determination of venous pressure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"38720","name":"Removal of lymph nodes neck","description":"Cervical lymphadenectomy (complete)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90466","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86602","name":"Antinomyces antibody","description":"Antibody; actinomyces","date_of_service":"2026-05-10","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":"31560","name":"Laryngoscop w/arytenoidectom","description":"Laryngoscopy, direct, operative, with arytenoidectomy;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48148","name":"Removal of pancreatic duct","description":"Excision of ampulla of vater","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":337.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74221","name":"X-ray xm esophagus 2cntrst","description":"Radiologic examination, esophagus, including scout chest radiograph(s) and delayed image(s), when performed; double-contrast (eg, high-density barium and effervescent agent) study","date_of_service":"2026-05-10","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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1366.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"88230","name":"Tissue culture lymphocyte","description":"Tissue culture for non-neoplastic disorders; lymphocyte","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72072","name":"X-ray exam thorac spine 3vws","description":"Radiologic examination, spine; thoracic, 3 views","date_of_service":"2026-05-10","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":"77054","name":"X-ray of mammary ducts","description":"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42860","name":"Excision of tonsil tags","description":"Excision of tonsil tags","date_of_service":"2026-05-10","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":"88349","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"L2090","name":"Hkafo unilat torsion ball br","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-05-10","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":"G2023","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2578.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92358","name":"Aphakia prosth service temp","description":"Prosthesis service for aphakia, temporary (disposable or loan, including materials)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"78282","name":"Gi protein loss","description":"Gastrointestinal protein loss","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6543","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":543.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54001","name":"Slitting of prepuce","description":"Slitting of prepuce, dorsal or lateral (separate procedure); except newborn","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75953","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B9004","name":"Parenteral infus pump portab","description":"Parenteral nutrition infusion pump, portable","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"E0158","name":"Walker leg extenders set of4","description":"Leg extensions for walker, per set of four (4)","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76150","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","date_of_service":"2026-05-10","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":"85175","name":"Blood clot lysis time","description":"Clot lysis time, whole blood dilution","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"92025","name":"Cptrized corneal topography","description":"Computerized corneal topography, unilateral or bilateral, with interpretation and report","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":856.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":995.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2044.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2943.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"38230","name":"Bone marrow harvest allogen","description":"Bone marrow harvesting for transplantation; allogeneic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":653.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75746","name":"Artery x-rays lung","description":"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84300","name":"Assay of urine sodium","description":"Sodium; urine","date_of_service":"2026-05-10","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":"74320","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","date_of_service":"2026-05-10","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":"84580","name":"Assay of urine urobilinogen","description":"Urobilinogen, urine; quantitative, timed specimen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A6209","name":"Foam drsg <=16 sq in w/o bdr","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"G0368","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"87290","name":"Varicella zoster ag if","description":"Infectious agent antigen detection by immunofluorescent technique; varicella zoster virus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6569","name":"G com garmnt torso/shdr cust","description":"Gradient compression garment, torso/shoulder, custom, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1499.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2469","name":"Palonosetron hcl","description":"Injection, palonosetron hcl, 25 mcg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6451","name":"Mod compres band w>=3in<5in/yd","description":"Moderate compression bandage, elastic, knitted/woven, load resistance of 1.25 to 1.34 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3350","name":"Shoe heel wedge","description":"Heel wedge","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"43611","name":"Excision of stomach lesion","description":"Excision, local; malignant tumor of stomach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1235.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"00542","name":"Anes thrcm px decortication","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); decortication","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"57700","name":"Revision of cervix","description":"Cerclage of uterine cervix, nonobstetrical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"56810","name":"Perineoplasty rpr per nonob","description":"Perineoplasty, repair of perineum, nonobstetrical (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00600","name":"Anes px crv spine&cord nos","description":"Anesthesia for procedures on cervical spine and cord; not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74018","name":"Radex abdomen 1 view","description":"Radiologic examination, abdomen; 1 view","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"79440","name":"Nuclear rx intra-articular","description":"Radiopharmaceutical therapy, by intra-articular administration","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":880.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"45100","name":"Biopsy of rectum","description":"Biopsy of anorectal wall, anal approach (eg, congenital megacolon)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"29020","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78000","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64866","name":"Fusion of facial/other nerve","description":"Anastomosis; facial-spinal accessory","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77305","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"27830","name":"Treat lower leg dislocation","description":"Closed treatment of proximal tibiofibular joint dislocation; without anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"95813","name":"Eeg extnd mntr 61-119 min","description":"Electroencephalogram (eeg) extended monitoring; 61-119 minutes","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59426","name":"Antepartum care only","description":"Antepartum care only; 7 or more visits","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-05-10","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":"82131","name":"Amino acids single quant","description":"Amino acids; single, quantitative, each specimen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"71100","name":"X-ray exam ribs uni 2 views","description":"Radiologic examination, ribs, unilateral; 2 views","date_of_service":"2026-05-10","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":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00350","name":"Anes px major vsl neck nos","description":"Anesthesia for procedures on major vessels of neck; not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"47135","name":"Transplantation of liver","description":"Liver allotransplantation, orthotopic, partial or whole, from cadaver or living donor, any age","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82441","name":"Test for chlorohydrocarbons","description":"Chlorinated hydrocarbons, screen","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"15757","name":"Free skin flap microvasc","description":"Free skin flap with microvascular anastomosis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1445.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-05-10","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":"96910","name":"Photchmtx tar&uvb/ptrltm&uvb","description":"Photochemotherapy; tar and ultraviolet b (goeckerman treatment) or petrolatum and ultraviolet b","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":717.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64858","name":"Repair sciatic nerve","description":"Suture of sciatic nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1401.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68020","name":"Incise/drain eyelid lining","description":"Incision of conjunctiva, drainage of cyst","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74182","name":"Mri abdomen w/contrast","description":"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94760","name":"N-invas ear/pls oximetry 1","description":"Noninvasive ear or pulse oximetry for oxygen saturation; single determination","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0880","name":"Trac stand free stand extrem","description":"Traction stand, free standing, extremity traction","date_of_service":"2026-05-10","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":"L3966","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1230.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"43247","name":"Egd remove foreign body","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of foreign body(s)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"A4563","name":"Vag inser rectal control sys","description":"Rectal control system for vaginal insertion, for long term use, includes pump and all supplies and accessories, any type each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":777.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"54056","name":"Cryosurgery penis lesion(s)","description":"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; cryosurgery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0353","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L6950","name":"Above elbow switch control","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93505","name":"Endomyocardial biopsy","description":"Endomyocardial biopsy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":713.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"27380","name":"Repair of kneecap tendon","description":"Suture of infrapatellar tendon; primary","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71120","name":"X-ray exam breastbone 2/>vws","description":"Radiologic examination; sternum, minimum of 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"69320","name":"Rebuild outer ear canal","description":"Reconstruction external auditory canal for congenital atresia, single stage","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27030","name":"Arthrotomy hip w/drainage","description":"Arthrotomy, hip, with drainage (eg, infection)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0108","name":"Diab manage trn  per indiv","description":"Diabetes outpatient self-management training services, individual, per 30 minutes","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54408","name":"Repair multi-comp penis pros","description":"Repair of component(s) of a multi-component, inflatable penile prosthesis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":847.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"10022","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q0035","name":"Cardiokymography","description":"Cardiokymography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":876.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1353","name":"Oxygen supplies regulator","description":"Regulator","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"86707","name":"Hepatitis be antibody","description":"Hepatitis be antibody (hbeab)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00215","name":"Anes icr px crnop/elvtn fx","description":"Anesthesia for intracranial procedures; cranioplasty or elevation of depressed skull fracture, extradural (simple or compound)","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84022","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1152.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01420","name":"Anes cst appl rmv/rpr kne jt","description":"Anesthesia for all cast applications, removal, or repair involving knee joint","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59160","name":"D & c after delivery","description":"Curettage, postpartum","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0436","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"52351","name":"Cystouretero & or pyeloscope","description":"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; diagnostic","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33015","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":553.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"78018","name":"Thyroid met imaging body","description":"Thyroid carcinoma metastases imaging; whole body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86705","name":"Hep b core antibody igm","description":"Hepatitis b core antibody (hbcab); igm antibody","date_of_service":"2026-05-10","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":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8613","name":"Ossicular implant","description":"Ossicula implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0739","name":"Rehab sys active assist rt","description":"Rehabilitation system with interactive interface providing active assistance in rehabilitation therapy, includes all components and accessories, motors, microprocessors, sensors","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"25119","name":"Partial removal of ulna","description":"Synovectomy, extensor tendon sheath, wrist, single compartment; with resection of distal ulna","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":669.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76350","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69540","name":"Excision aural polyp","description":"Excision aural polyp","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":735.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95052","name":"Photo patch tests","description":"Photo patch test(s) (specify number of tests)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9208","name":"Ifosfamide injection","description":"Injection, ifosfamide, 1 gram","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3621.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":846.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1226.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28341","name":"Resect enlarged toe","description":"Reconstruction, toe, macrodactyly; requiring bone resection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":540.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1603.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26476","name":"Tendon lengthening","description":"Lengthening of tendon, extensor, hand or finger, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0700","name":"Safety equipment","description":"Safety equipment, device or accessory, any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"31291","name":"Nasal/sinus endoscopy surg","description":"Nasal/sinus endoscopy, surgical, with repair of cerebrospinal fluid leak; sphenoid region","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"65805","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23430","name":"Repair biceps tendon","description":"Tenodesis of long tendon of biceps","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":904.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5250","name":"Hip canad sing axi cons fric","description":"Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2749.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96154","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86800","name":"Thyroglobulin antibody","description":"Thyroglobulin antibody","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66635","name":"Removal of iris","description":"Iridectomy, with corneoscleral or corneal section; optical (separate procedure)","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"32651","name":"Thoracoscopy remove cortex","description":"Thoracoscopy, surgical; with partial pulmonary decortication","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":874.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"88264","name":"Chromosome analysis 20-25","description":"Chromosome analysis; analyze 20-25 cells","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1298","name":"Wheelchair spec seat depth/w","description":"Special wheelchair seat depth and/or width, by construction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77421","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"15350","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":377.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24362","name":"Reconstruct elbow joint","description":"Arthroplasty, elbow; with implant and fascia lata ligament reconstruction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1257.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93971","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study","date_of_service":"2026-05-10","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":"78455","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":720.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28496","name":"Treat big toe fracture","description":"Percutaneous skeletal fixation of fracture great toe, phalanx or phalanges, with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29904","name":"Subtalar arthro w/fb rmvl","description":"Arthroscopy, subtalar joint, surgical; with removal of loose body or foreign body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35646","name":"Bpg aortobifemoral","description":"Bypass graft, with other than vein; aortobifemoral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1511.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4207","name":"2 cc sterile syringe&needle","description":"Syringe with needle, sterile 2 cc, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":706.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6025","name":"Silicone gel sheet, each","description":"Gel sheet for dermal or epidermal application, (e.g., silicone, hydrogel, other), each","date_of_service":"2026-05-10","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":"51784","name":"Anal/urinary muscle study","description":"Electromyography studies (emg) of anal or urethral sphincter, other than needle, any technique","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95864","name":"Needle emg 4 extremities","description":"Needle electromyography; 4 extremities with or without related paraspinal areas","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"97039","name":"Unlisted modality","description":"Unlisted modality (specify type and time if constant attendance)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","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":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1978.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":543.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1621.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48511","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"93610","name":"Intra-atrial pacing","description":"Intra-atrial pacing","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":642.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"74480","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27407","name":"Repair of knee ligament","description":"Repair, primary, torn ligament and/or capsule, knee; cruciate","date_of_service":"2026-05-10","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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00170","name":"Anes intraoral px nos","description":"Anesthesia for intraoral procedures, including biopsy; not otherwise specified","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2829.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1752","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3740","name":"Cuffs adj lock w/ active con","description":"Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"15810","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1212.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"89100","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94729","name":"Diffusing capacity","description":"Diffusing capacity (eg, carbon monoxide, membrane) (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5812","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":723.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"37790","name":"Penile venous occlusion","description":"Penile venous occlusive procedure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74430","name":"Contrast x-ray bladder","description":"Cystography, minimum of 3 views, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"32671","name":"Thoracoscopy pneumonectomy","description":"Thoracoscopy, surgical; with removal of lung (pneumonectomy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"85130","name":"Chromogenic substrate assay","description":"Chromogenic substrate assay","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1701.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21215","name":"Lower jaw bone graft","description":"Graft, bone; mandible (includes obtaining graft)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96410","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0149T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0968","name":"Wheelchair commode seat","description":"Commode seat, wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35454","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93278","name":"Ecg/signal-averaged","description":"Signal-averaged electrocardiography (saecg), with or without ecg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52353","name":"Cystouretero w/lithotripsy","description":"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1232.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22904","name":"Radical resect abd tumor<5cm","description":"Radical resection of tumor (eg, sarcoma), soft tissue of abdominal wall; less than 5 cm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37780","name":"Revision of leg vein","description":"Ligation and division of short saphenous vein at saphenopopliteal junction (separate procedure)","date_of_service":"2026-05-10","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":"95812","name":"Eeg 41-60 minutes","description":"Electroencephalogram (eeg) extended monitoring; 41-60 minutes","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2526","name":"Th/wght bear nar m-l brim cu","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"26555","name":"Positional change of finger","description":"Transfer, finger to another position without microvascular anastomosis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1705.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"72074","name":"X-ray exam thorac spine4/>vw","description":"Radiologic examination, spine; thoracic, minimum of 4 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65400","name":"Removal of eye lesion","description":"Excision of lesion, cornea (keratectomy, lamellar, partial), except pterygium","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78272","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"86063","name":"Antistreptolysin o screen","description":"Antistreptolysin 0; screen","date_of_service":"2026-05-10","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":"L3031","name":"Foot lamin/prepreg composite","description":"Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E0783","name":"Programmable infusion pump","description":"Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3546.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83896","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"J2805","name":"Sincalide injection","description":"Injection, sincalide, 5 micrograms","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83500","name":"Assay free hydroxyproline","description":"Hydroxyproline; free","date_of_service":"2026-05-10","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":"85014","name":"Hematocrit","description":"Blood count; hematocrit (hct)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"28445","name":"Optx talus fracture","description":"Open treatment of talus fracture, includes internal fixation, when performed","date_of_service":"2026-05-10","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":"ATP18","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"42225","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate; attachment pharyngeal flap","date_of_service":"2026-05-10","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":"91200","name":"Liver elastography","description":"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":"22224","name":"Osteot dsc ant 1vrt sgm lmbr","description":"Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; lumbar","date_of_service":"2026-05-10","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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-10","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":"84066","name":"Assay prostate phosphatase","description":"Phosphatase, acid; prostatic","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5100","name":"Molded socket shin sach foot","description":"Below knee, molded socket, shin, sach foot","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["95","ET"]}],"provider_references":[7]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["95","ET"]}],"provider_references":[2]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["95","ET"]}],"provider_references":[6]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["95","ET"]}],"provider_references":[5]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["95","ET"]}],"provider_references":[1]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["95","ET"]}],"provider_references":[4]},{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["95","ET"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"24495","name":"Decompression fasct forearm","description":"Decompression fasciotomy, forearm, with brachial artery exploration","date_of_service":"2026-05-10","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":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","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":"L5250","name":"Hip canad sing axi cons fric","description":"Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1518.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62201","name":"Brain cavity shunt w/scope","description":"Ventriculocisternostomy, third ventricle; stereotactic, neuroendoscopic method","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1093.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73100","name":"X-ray exam of wrist","description":"Radiologic examination, wrist; 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28153","name":"Partial removal of toe","description":"Resection, condyle(s), distal end of phalanx, each toe","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"93610","name":"Intra-atrial pacing","description":"Intra-atrial pacing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"24340","name":"Tenodesis biceps tdn at elbw","description":"Tenodesis of biceps tendon at elbow (separate procedure)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"27495","name":"Reinforce thigh","description":"Prophylactic treatment (nailing, pinning, plating, or wiring) with or without methylmethacrylate, femur","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1351.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7197","name":"Antithrombin iii injection","description":"Antithrombin iii (human), per i.u.","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L0636","name":"Lso sagittal rigid panel cus","description":"Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressu","date_of_service":"2026-05-10","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":"36000","name":"Place needle in vein","description":"Introduction of needle or intracatheter, vein","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"26548","name":"Reconstruct finger joint","description":"Repair and reconstruction, finger, volar plate, interphalangeal joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1018.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"19325","name":"Breast augmentation w/implt","description":"Breast augmentation with implant","date_of_service":"2026-05-10","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":"84510","name":"Assay of tyrosine","description":"Tyrosine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78320","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35541","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1816.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75945","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28660","name":"Treat toe dislocation","description":"Closed treatment of interphalangeal joint dislocation; without anesthesia","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"66225","name":"Repair/graft eye lesion","description":"Repair of scleral staphyloma with graft","date_of_service":"2026-05-10","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":"23430","name":"Repair biceps tendon","description":"Tenodesis of long tendon of biceps","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6223","name":"Gauze >16<=48 no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","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":"23174","name":"Sqstrctmy humrl head srg nck","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), humeral head to surgical neck","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96446","name":"Chemotx admn pertl cav impl","description":"Chemotherapy administration into the peritoneal cavity via implanted port or catheter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20802","name":"Replantation arm complete","description":"Replantation, arm (includes surgical neck of humerus through elbow joint), complete amputation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"85670","name":"Thrombin time plasma","description":"Thrombin time; plasma","date_of_service":"2026-05-10","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":"G6012","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"01140","name":"Anes ntrplvabdmnl amputation","description":"Anesthesia for interpelviabdominal (hindquarter) amputation","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":364.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":978.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"59121","name":"Treat ectopic pregnancy","description":"Surgical treatment of ectopic pregnancy; tubal or ovarian, without salpingectomy and/or oophorectomy","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62311","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"44640","name":"Repair bowel-skin fistula","description":"Closure of intestinal cutaneous fistula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1463.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"L5560","name":"Prep ak ischial plast molded","description":"Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63200","name":"Release spinal cord lumbar","description":"Laminectomy, with release of tethered spinal cord, lumbar","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4425","name":"Ost pch drain for barrier fl","description":"Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"60512","name":"Autotransplant parathyroid","description":"Parathyroid autotransplantation (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27664","name":"Repair of leg tendon each","description":"Repair, extensor tendon, leg; primary, without graft, each tendon","date_of_service":"2026-05-10","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":"38794","name":"Access thoracic lymph duct","description":"Cannulation, thoracic duct","date_of_service":"2026-05-10","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":"75554","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6246","name":"Hydrogel drg >16<=48 in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"20101","name":"Expl pentrg wound chest","description":"Exploration of penetrating wound (separate procedure); chest","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28605","name":"Treat foot dislocation","description":"Closed treatment of tarsometatarsal joint dislocation; requiring anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":530.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77785","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87622","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-10","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":"J1745","name":"Infliximab not biosimil 10mg","description":"Injection, infliximab, excludes biosimilar, 10 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-05-10","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":"83993","name":"Assay for calprotectin fecal","description":"Calprotectin, fecal","date_of_service":"2026-05-10","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":"61480","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2247.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"G0351","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.64,"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":"27105","name":"Transfer of spinal muscle","description":"Transfer paraspinal muscle to hip (includes fascial or tendon extension graft)","date_of_service":"2026-05-10","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":"33947","name":"Ecmo/ecls initiation artery","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; initiation, veno-arterial","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92260","name":"Ophthalmodynamometry","description":"Ophthalmodynamometry","date_of_service":"2026-05-10","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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67405","name":"Explore/drain eye socket","description":"Orbitotomy without bone flap (frontal or transconjunctival approach); with drainage only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80186","name":"Assay of phenytoin free","description":"Phenytoin; free","date_of_service":"2026-05-10","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":"32601","name":"Thoracoscopy diagnostic","description":"Thoracoscopy, diagnostic (separate procedure); lungs, pericardial sac, mediastinal or pleural space, without biopsy","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"32215","name":"Treat chest lining","description":"Pleural scarification for repeat pneumothorax","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":890.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2110","name":"Spherocylinder 4.25d/over 6d","description":"Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"22523","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":740.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A4541","name":"Monthly supp use with e0733","description":"Monthly supplies for use of device coded at e0733","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46210","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78120","name":"Red cell mass single","description":"Red cell volume determination (separate procedure); single sampling","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36455","name":"Bld exchange truj oth thn nb","description":"Exchange transfusion, blood; other than newborn","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J9209","name":"Mesna injection","description":"Injection, mesna, 200 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00212","name":"Anes icr px subdural taps","description":"Anesthesia for intracranial procedures; subdural taps","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38382","name":"Thoracic duct procedure","description":"Suture and/or ligation of thoracic duct; abdominal approach","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","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":"27332","name":"Removal of knee cartilage","description":"Arthrotomy, with excision of semilunar cartilage (meniscectomy) knee; medial or lateral","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3929","name":"Hfo nontorsion jnts pre cst","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","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":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KC"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1677.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L3660","name":"So 8 ab rstr can/web pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":921.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75998","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":642.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63251","name":"Revise spinal cord vsls thrc","description":"Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3407.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3134.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"0072A","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"L6665","name":"Teflon or equal cable lining","description":"Upper extremity addition, teflon, or equal, cable lining","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":512.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"65800","name":"Drainage of eye","description":"Paracentesis of anterior chamber of eye (separate procedure); with removal of aqueous","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"79445","name":"Nuclear rx intra-arterial","description":"Radiopharmaceutical therapy, by intra-arterial particulate administration","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L0460","name":"Tlso 2 shl symphys-stern cst","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the s","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":374.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1289.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":680.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-10","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":"76498","name":"Unlisted mr procedure","description":"Unlisted magnetic resonance procedure (eg, diagnostic, interventional)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":672.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3701","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"38240","name":"Transplt allo hct/donor","description":"Hematopoietic progenitor cell (hpc); allogeneic transplantation per donor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86340","name":"Intrinsic factor antibody","description":"Intrinsic factor antibodies","date_of_service":"2026-05-10","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":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-10","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":"77075","name":"Radex osseous survey compl","description":"Radiologic examination, osseous survey; complete (axial and appendicular skeleton)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84446","name":"Assay of vitamin e","description":"Tocopherol alpha (vitamin e)","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"J0205","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A9512","name":"Tc99m pertechnetate","description":"Technetium tc-99m pertechnetate, diagnostic, per millicurie","date_of_service":"2026-05-10","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":"67110","name":"Repair detached retina","description":"Repair of retinal detachment; by injection of air or other gas (eg, pneumatic retinopexy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"33875","name":"Thoracic aortic graft","description":"Descending thoracic aorta graft, with or without bypass","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"L5311","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1070","name":"Wheelchair detachable foot r","description":"Fully-reclining wheelchair, detachable arms (desk or full length) swing away detachable footrest","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"3074F","name":"Syst bp lt 130 mm hg","description":"Most recent systolic blood pressure less than 130 mm hg (dm) (htn, ckd, cad)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95937","name":"Neuromuscular junction test","description":"Neuromuscular junction testing (repetitive stimulation, paired stimuli), each nerve, any 1 method","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"92235","name":"Fluorescein angrph mltiframe","description":"Fluorescein angiography (includes multiframe imaging) with interpretation and report, unilateral or bilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-05-10","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":"88150","name":"Cytopath c/v manual","description":"Cytopathology, slides, cervical or vaginal; manual screening under physician supervision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76090","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5344.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59612","name":"Vbac delivery only","description":"Vaginal delivery only, after previous cesarean delivery (with or without episiotomy and/or forceps);","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63277","name":"Bx/exc xdrl spine lesn lmbr","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, lumbar","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1399.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71015","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"92567","name":"Tympanometry","description":"Tympanometry (impedance testing)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"38724","name":"Removal of lymph nodes neck","description":"Cervical lymphadenectomy (modified radical neck dissection)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":912.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43135","name":"Removal of esophagus pouch","description":"Diverticulectomy of hypopharynx or esophagus, with or without myotomy; thoracic approach","date_of_service":"2026-05-10","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":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1230","name":"Power operated vehicle","description":"Power operated vehicle (three or four wheel nonhighway) specify brand name and model number","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"78278","name":"Acute gi blood loss imaging","description":"Acute gastrointestinal blood loss imaging","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85410","name":"Fibrinolytic antiplasmin","description":"Fibrinolytic factors and inhibitors; alpha-2 antiplasmin","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4415","name":"Ost skn barr w/o conv >4 sqi","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"21120","name":"Genioplasty augmentation","description":"Genioplasty; augmentation (autograft, allograft, prosthetic material)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":597.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"23100","name":"Arthrotomy glenhumrl jt w/bx","description":"Arthrotomy, glenohumeral joint, including biopsy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95857","name":"Cholinesterase challenge","description":"Cholinesterase inhibitor challenge test for myasthenia gravis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70190","name":"X-ray exam of eye sockets","description":"Radiologic examination; optic foramina","date_of_service":"2026-05-10","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":"75726","name":"Artery x-rays abdomen","description":"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"61690","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; dural, simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2442.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"25365","name":"Revise radius & ulna","description":"Osteotomy; radius and ulna","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"87808","name":"Trichomonas assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; trichomonas vaginalis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94620","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74328","name":"X-ray bile duct endoscopy","description":"Endoscopic catheterization of the biliary ductal system, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q0091","name":"Obtaining screen pap smear","description":"Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory","date_of_service":"2026-05-10","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":"78615","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44602","name":"Suture small intestine","description":"Suture of small intestine (enterorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture; single perforation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1088.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","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":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"46762","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"L1980","name":"Afo sing solid stirrup calf","description":"Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar bk orthosis), custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21445","name":"Optx mndblr/max alv ridge fx","description":"Open treatment of mandibular or maxillary alveolar ridge fracture (separate procedure)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4407","name":"Ext wear ost skn barr <=4sqin","description":"Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"ATP02","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"32110","name":"Explore/repair chest","description":"Thoracotomy; with control of traumatic hemorrhage and/or repair of lung tear","date_of_service":"2026-05-10","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":"G0202","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44212","name":"Laparo total proctocolectomy","description":"Laparoscopy, surgical; colectomy, total, abdominal, with proctectomy, with ileostomy","date_of_service":"2026-05-10","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":"A4247","name":"Betadine/iodine swabs/wipes","description":"Betadine or iodine swabs/wipes, per box","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"58825","name":"Transposition ovary(s)","description":"Transposition, ovary(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A5504","name":"Diabetic shoe with wedge","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe","date_of_service":"2026-05-10","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":"G0505","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84315","name":"Body fluid specific gravity","description":"Specific gravity (except urine)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1382.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7402","name":"Add ue prost s/d ultlite mat","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":556.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4234","name":"J-cell batt for glucose mon","description":"Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"21338","name":"Open nasoethmoid fx w/o fixj","description":"Open treatment of nasoethmoid fracture; without external fixation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":532.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82370","name":"X-ray assay calculus","description":"Calculus; x-ray diffraction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7017","name":"Nebulizer not used w oxygen","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen","date_of_service":"2026-05-10","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":"J9062","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"66720","name":"Destruction ciliary body","description":"Ciliary body destruction; cryotherapy","date_of_service":"2026-05-10","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":"66850","name":"Removal of lens material","description":"Removal of lens material; phacofragmentation technique (mechanical or ultrasonic) (eg, phacoemulsification), with aspiration","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28285","name":"Repair of hammertoe","description":"Correction, hammertoe (eg, interphalangeal fusion, partial or total phalangectomy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0300","name":"Enclosed ped crib hosp grade","description":"Pediatric crib, hospital grade, fully enclosed, with or without top enclosure","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99436","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2719.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43234","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":672.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1421.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97750","name":"Physical performance test","description":"Physical performance test or measurement (eg, musculoskeletal, functional capacity), with written report, each 15 minutes","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51741","name":"Electro-uroflowmetry first","description":"Complex uroflowmetry (eg, calibrated electronic equipment)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"84295","name":"Assay of serum sodium","description":"Sodium; serum, plasma or whole blood","date_of_service":"2026-05-10","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":"L8624","name":"Lith ion batt cid, ear level","description":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97039","name":"Unlisted modality","description":"Unlisted modality (specify type and time if constant attendance)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":689.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78812","name":"Pet image skull-thigh","description":"Positron emission tomography (pet) imaging; skull base to mid-thigh","date_of_service":"2026-05-10","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":"A6255","name":"Absorpt drg >16<=48 in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"50760","name":"Ureteroureterostomy","description":"Ureteroureterostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":936.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72100","name":"X-ray exam l-s spine 2/3 vws","description":"Radiologic examination, spine, lumbosacral; 2 or 3 views","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"20920","name":"Removal of fascia for graft","description":"Fascia lata graft; by stripper","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78290","name":"Intestine imaging","description":"Intestine imaging (eg, ectopic gastric mucosa, meckels localization, volvulus)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51080","name":"Drainage of bladder abscess","description":"Drainage of perivesical or prevesical space abscess","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64744","name":"Incise nerve back of head","description":"Transection or avulsion of; greater occipital nerve","date_of_service":"2026-05-10","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":"92370","name":"Rpr&refitg spect xcp aphakia","description":"Repair and refitting spectacles; except for aphakia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45150","name":"Excision of rectal stricture","description":"Division of stricture of rectum","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"76870","name":"Us exam scrotum","description":"Ultrasound, scrotum and contents","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q0091","name":"Obtaining screen pap smear","description":"Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58770","name":"Create new tubal opening","description":"Salpingostomy (salpingoneostomy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1007.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"32658","name":"Thoracoscopy w/sac fb remove","description":"Thoracoscopy, surgical; with removal of clot or foreign body from pericardial sac","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":928.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J9091","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"G0120","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"87172","name":"Pinworm exam","description":"Pinworm exam (eg, cellophane tape prep)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"88147","name":"Cytopath c/v automated","description":"Cytopathology smears, cervical or vaginal; screening by automated system under physician supervision","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","date_of_service":"2026-05-10","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":"L6955","name":"Above elbow myoelectronic ct","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5925.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70328","name":"X-ray exam of jaw joint","description":"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral","date_of_service":"2026-05-10","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":"19100","name":"Bx breast percut w/o image","description":"Biopsy of breast; percutaneous, needle core, not using imaging guidance (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"43254","name":"Egd endo mucosal resection","description":"Esophagogastroduodenoscopy, flexible, transoral; with endoscopic mucosal resection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5500","name":"Diab shoe for density insert","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1001.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"24065","name":"Biopsy arm/elbow soft tissue","description":"Biopsy, soft tissue of upper arm or elbow area; superficial","date_of_service":"2026-05-10","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":"69714","name":"Impl oi implt skull perq esp","description":"Implantation, osseointegrated implant, skull; with percutaneous attachment to external speech processor","date_of_service":"2026-05-10","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":"25650","name":"Cltx ulnar styloid fracture","description":"Closed treatment of ulnar styloid fracture","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94750","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92982","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84066","name":"Assay prostate phosphatase","description":"Phosphatase, acid; prostatic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KF"]}],"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":"2026-05-10","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":"27591","name":"Amputate leg at thigh","description":"Amputation, thigh, through femur, any level; immediate fitting technique including first cast","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1055.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"73580","name":"Contrast x-ray of knee joint","description":"Radiologic examination, knee, arthrography, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"23035","name":"Incision bone cortex sho","description":"Incision, bone cortex (eg, osteomyelitis or bone abscess), shoulder area","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":839.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"V5020","name":"Conformity evaluation","description":"Conformity evaluation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"88349","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24066","name":"Biopsy arm/elbow soft tissue","description":"Biopsy, soft tissue of upper arm or elbow area; deep (subfascial or intramuscular)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33130","name":"Rescj external cardiac tumor","description":"Resection of external cardiac tumor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","date_of_service":"2026-05-10","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":"37617","name":"Ligation major artery abd","description":"Ligation, major artery (eg, post-traumatic, rupture); abdomen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33803","name":"Div aberrant vsl w/reanast","description":"Division of aberrant vessel (vascular ring); with reanastomosis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1468.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64420","name":"Njx aa&/strd ntrcost nrv 1","description":"Injection(s), anesthetic agent(s) and/or steroid; intercostal nerve, single level","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q9948","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27696","name":"Repair of ankle ligaments","description":"Repair, primary, disrupted ligament, ankle; both collateral ligaments","date_of_service":"2026-05-10","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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-05-10","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":"71035","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27033","name":"Arthrt hip expl/rmv loose/fb","description":"Arthrotomy, hip, including exploration or removal of loose or foreign body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90821","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28116","name":"Revision of foot","description":"Ostectomy, excision of tarsal coalition","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67902","name":"Repair eyelid defect","description":"Repair of blepharoptosis; frontalis muscle technique with autologous fascial sling (includes obtaining fascia)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"27727","name":"Repair of lower leg","description":"Repair of congenital pseudarthrosis, tibia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85335","name":"Factor inhibitor test","description":"Factor inhibitor test","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70110","name":"X-ray exam of jaw 4/> views","description":"Radiologic examination, mandible; complete, minimum of 4 views","date_of_service":"2026-05-10","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":"A6223","name":"Gauze >16<=48 no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47554","name":"Biliary endoscopy thru skin","description":"Biliary endoscopy, percutaneous via t-tube or other tract; with removal of calculus/calculi","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":588.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"83055","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-10","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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1831","name":"Static str toe dev ext/flex","description":"Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","date_of_service":"2026-05-10","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":"25611","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"95812","name":"Eeg 41-60 minutes","description":"Electroencephalogram (eeg) extended monitoring; 41-60 minutes","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58750","name":"Repair oviduct","description":"Tubotubal anastomosis","date_of_service":"2026-05-10","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":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","date_of_service":"2026-05-10","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":"30930","name":"Ther fx nasal inf turbinate","description":"Fracture nasal inferior turbinate(s), therapeutic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95903","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"95934","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"43633","name":"Removal of stomach partial","description":"Gastrectomy, partial, distal; with roux-en-y reconstruction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1578.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"17360","name":"Chemical exfoliation acne","description":"Chemical exfoliation for acne (eg, acne paste, acid)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86038","name":"Antinuclear antibodies","description":"Antinuclear antibodies (ana);","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"88188","name":"Flowcytometry/read 9-15","description":"Flow cytometry, interpretation; 9 to 15 markers","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"96002","name":"Dynamic surface emg","description":"Dynamic surface electromyography, during walking or other functional activities, 1-12 muscles","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3211","name":"Surgical boot each junior","description":"Surgical boot, each, junior","date_of_service":"2026-05-10","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":"27147","name":"Revision of hip bone","description":"Osteotomy, iliac, acetabular or innominate bone; with open reduction of hip","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1700.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1433.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["26"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82642","name":"Dihydrotestosterone","description":"Dihydrotestosterone (dht)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55530","name":"Revise spermatic cord veins","description":"Excision of varicocele or ligation of spermatic veins for varicocele; (separate procedure)","date_of_service":"2026-05-10","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":"57106","name":"Vagnc prtl rmvl vag wall","description":"Vaginectomy, partial removal of vaginal wall;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"15421","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2748.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"61544","name":"Remove & treat brain lesion","description":"Craniotomy with elevation of bone flap; for excision or coagulation of choroid plexus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87450","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92582","name":"Conditioning play audiometry","description":"Conditioning play audiometry","date_of_service":"2026-05-10","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":"82160","name":"Assay of androsterone","description":"Androsterone","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54520","name":"Removal of testis","description":"Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"27246","name":"Treat thigh fracture","description":"Closed treatment of greater trochanteric fracture, without manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45379","name":"Colonoscopy w/fb removal","description":"Colonoscopy, flexible; with removal of foreign body(s)","date_of_service":"2026-05-10","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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"15835","name":"Exc excessive skin buttock","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); buttock","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"83070","name":"Assay of hemosiderin qual","description":"Hemosiderin, qualitative","date_of_service":"2026-05-10","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":"G0462","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4396","name":"Static or dynami afo pre cst","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90636","name":"Hep a/hep b vacc adult im","description":"Hepatitis a and hepatitis b vaccine (hepa-hepb), adult dosage, for intramuscular use","date_of_service":"2026-05-10","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":161.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"21630","name":"Radical resection sternum","description":"Radical resection of sternum","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77431","name":"Radiation therapy management","description":"Radiation therapy management with complete course of therapy consisting of 1 or 2 fractions only","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"96542","name":"Chemotherapy injection","description":"Chemotherapy injection, subarachnoid or intraventricular via subcutaneous reservoir, single or multiple agents","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1558.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-10","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":"31090","name":"Exploration of sinuses","description":"Sinusotomy, unilateral, 3 or more paranasal sinuses (frontal, maxillary, ethmoid, sphenoid)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","date_of_service":"2026-05-10","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":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-10","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":"67914","name":"Repair eyelid defect","description":"Repair of ectropion; suture","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82378","name":"Carcinoembryonic antigen","description":"Carcinoembryonic antigen (cea)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G0319","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E0171","name":"Commode chair non-electric","description":"Commode chair with integrated seat lift mechanism, non-electric, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50590","name":"Fragmenting of kidney stone","description":"Lithotripsy, extracorporeal shock wave","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"64910","name":"Nerve repair w/allograft","description":"Nerve repair; with synthetic conduit or vein allograft (eg, nerve tube), each nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27580","name":"Fusion of knee","description":"Arthrodesis, knee, any technique","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4602.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78585","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2232","name":"Rocker bottom, contact afo","description":"Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88108","name":"Cytopath concentrate tech","description":"Cytopathology, concentration technique, smears and interpretation (eg, saccomanno technique)","date_of_service":"2026-05-10","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48020","name":"Removal of pancreatic stone","description":"Removal of pancreatic calculus","date_of_service":"2026-05-10","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":"75724","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-05-10","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":"L1840","name":"Ko derot ant cruciate custom","description":"Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1159.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27391","name":"Incision of thigh tendons","description":"Tenotomy, open, hamstring, knee to hip; multiple tendons, 1 leg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"53442","name":"Remove/revise male sling","description":"Removal or revision of sling for male urinary incontinence (eg, fascia or synthetic)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":780.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01932","name":"Anes th ivnt rad ntrthrc/jug","description":"Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation); intrathoracic or jugular","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"33305","name":"Repair of heart wound","description":"Repair of cardiac wound; with cardiopulmonary bypass","date_of_service":"2026-05-10","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":"86658","name":"Enterovirus antibody","description":"Antibody; enterovirus (eg, coxsackie, echo, polio)","date_of_service":"2026-05-10","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":"76977","name":"Us bone density measure","description":"Ultrasound bone density measurement and interpretation, peripheral site(s), any method","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6222","name":"Gauze <=16 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78445","name":"Vascular flow imaging","description":"Non-cardiac vascular flow imaging (ie, angiography, venography)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54512","name":"Excise lesion testis","description":"Excision of extraparenchymal lesion of testis","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21630","name":"Radical resection sternum","description":"Radical resection of sternum","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1227","name":"Wheelchair spec sz spec ht a","description":"Special height arms for wheelchair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85421","name":"Fibrinolytic plasminogen","description":"Fibrinolytic factors and inhibitors; plasminogen, antigenic assay","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","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":"54001","name":"Slitting of prepuce","description":"Slitting of prepuce, dorsal or lateral (separate procedure); except newborn","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27709","name":"Osteotomy tibia & fibula","description":"Osteotomy; tibia and fibula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":903.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26742","name":"Treat finger fracture each","description":"Closed treatment of articular fracture, involving metacarpophalangeal or interphalangeal joint; with manipulation, each","date_of_service":"2026-05-10","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":"91020","name":"Gastric motility studies","description":"Gastric motility (manometric) studies","date_of_service":"2026-05-10","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":"54164","name":"Frenulotomy of penis","description":"Frenulotomy of penis","date_of_service":"2026-05-10","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":"99170","name":"Anogenital exam child w imag","description":"Anogenital examination, magnified, in childhood for suspected trauma, including image recording when performed","date_of_service":"2026-05-10","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":"71100","name":"X-ray exam ribs uni 2 views","description":"Radiologic examination, ribs, unilateral; 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1332.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"73130","name":"X-ray exam of hand","description":"Radiologic examination, hand; minimum of 3 views","date_of_service":"2026-05-10","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":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","date_of_service":"2026-05-10","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":"25315","name":"Revise palsy hand tendon(s)","description":"Flexor origin slide (eg, for cerebral palsy, volkmann contracture), forearm and/or wrist;","date_of_service":"2026-05-10","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":"43231","name":"Esophagoscop ultrasound exam","description":"Esophagoscopy, flexible, transoral; with endoscopic ultrasound examination","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"82103","name":"Alpha-1-antitrypsin total","description":"Alpha-1-antitrypsin; total","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61692","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; dural, complex","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"64412","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2109","name":"Spherocylinder 4.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0326","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"27090","name":"Removal of hip prosthesis","description":"Removal of hip prosthesis; (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":703.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88381","name":"Microdissection manual","description":"Microdissection (ie, sample preparation of microscopically identified target); manual","date_of_service":"2026-05-10","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":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73502","name":"X-ray exam hip uni 2-3 views","description":"Radiologic examination, hip, unilateral, with pelvis when performed; 2-3 views","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"00846","name":"Anes iper px rad hystrectomy","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; radical hysterectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9390","name":"Vinorelbine tartrate inj","description":"Injection, vinorelbine tartrate, 10 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2221","name":"Ank mcrop plant & dorsi flex","description":"Addition to lower extremity orthosis, ankle system, microprocessor-controlled feature plantarflexion and/or dorsiflexion, includes power source","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"52204","name":"Cystoscopy w/biopsy(s)","description":"Cystourethroscopy, with biopsy(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"3077F","name":"Syst bp >= 140 mm hg","description":"Most recent systolic blood pressure greater than or equal to 140 mm hg (htn, ckd, cad) (dm)","date_of_service":"2026-05-10","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":2.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-10","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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0786","name":"Implantable pump replacement","description":"Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KF"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":"J0595","name":"Butorphanol tartrate 1 mg","description":"Injection, butorphanol tartrate, 1 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70332","name":"X-ray exam of jaw joint","description":"Temporomandibular joint arthrography, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4254.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21032","name":"Remove exostosis maxilla","description":"Excision of maxillary torus palatinus","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01860","name":"Anes forearm wrist/hand cast","description":"Anesthesia for forearm, wrist, or hand cast application, removal, or repair","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":720.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"46740","name":"Construction of absent anus","description":"Repair of high imperforate anus with rectourethral or rectovaginal fistula; perineal or sacroperineal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1798.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"75952","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29867","name":"Allgrft implnt knee w/scope","description":"Arthroscopy, knee, surgical; osteochondral allograft (eg, mosaicplasty)","date_of_service":"2026-05-10","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":"71046","name":"X-ray exam chest 2 views","description":"Radiologic examination, chest; 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33922","name":"Transect pulmonary artery","description":"Transection of pulmonary artery with cardiopulmonary bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0120","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"88385","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"83986","name":"Assay ph body fluid nos","description":"Ph; body fluid, not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","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":"71110","name":"X-ray exam ribs bil 3 views","description":"Radiologic examination, ribs, bilateral; 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92542","name":"Positional nystagmus test","description":"Positional nystagmus test, minimum of 4 positions, with recording","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1020.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1511.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"86702","name":"Hiv-2 antibody","description":"Antibody; hiv-2","date_of_service":"2026-05-10","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":"V2783","name":"Lens, >= 1.66 p/>=1.80 g","description":"Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"52510","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":922.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76082","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-10","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":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":723.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L0112","name":"Cranial cervical orthosis","description":"Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99275","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6610","name":"G com stcking bk 18-30 custm","description":"Gradient compression stocking, below knee, 18-30 mmhg, custom, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"00910","name":"Anes transurethral px nos","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); not otherwise specified","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J2400","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"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":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"38505","name":"Needle biopsy lymph nodes","description":"Biopsy or excision of lymph node(s); by needle, superficial (eg, cervical, inguinal, axillary)","date_of_service":"2026-05-10","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":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1133.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6890","name":"Prefab glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49654","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01634","name":"Anes open/arthrs sho disrtcj","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; shoulder disarticulation","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1250.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69200","name":"Clear outer ear canal","description":"Removal foreign body from external auditory canal; without general anesthesia","date_of_service":"2026-05-10","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":"21210","name":"Face bone graft","description":"Graft, bone; nasal, maxillary or malar areas (includes obtaining graft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":944.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6455","name":"Self-adher band >=5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0636","name":"Pt support & positioning sys","description":"Multipositional patient support system, with integrated lift, patient accessible controls","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":735.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"69604","name":"Revj mstdc rsltg tympanplsty","description":"Revision mastoidectomy; resulting in tympanoplasty","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":897.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"96405","name":"Chemo intralesional up to 7","description":"Chemotherapy administration; intralesional, up to and including 7 lesions","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2026.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6246","name":"Hydrogel drg >16<=48 in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-10","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":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"37207","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-10","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":"21110","name":"Interdental fixation","description":"Application of interdental fixation device for conditions other than fracture or dislocation, includes removal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":653.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"15600","name":"Delay flap trunk","description":"Delay of flap or sectioning of flap (division and inset); at trunk","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"92609","name":"Use of speech device service","description":"Therapeutic services for the use of speech-generating device, including programming and modification","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1544.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28360","name":"Reconstruct cleft foot","description":"Reconstruction, cleft foot","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","date_of_service":"2026-05-10","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":"99226","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"L3700","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70200","name":"X-ray exam of eye sockets","description":"Radiologic examination; orbits, complete, minimum of 4 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":"36591","name":"Draw blood off venous device","description":"Collection of blood specimen from a completely implantable venous access device","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","date_of_service":"2026-05-10","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":"27601","name":"Decompression of lower leg","description":"Decompression fasciotomy, leg; posterior compartment(s) only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":512.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6582","name":"Wrist/elbow bowden cbl dir f","description":"Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-10","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":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"56637","name":"Vlvctmy rad comp bi lymphad","description":"Vulvectomy, radical, complete; with bilateral inguinofemoral lymphadenectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":947.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1890.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77421","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20920","name":"Removal of fascia for graft","description":"Fascia lata graft; by stripper","date_of_service":"2026-05-10","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":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50405","name":"Revision of kidney/ureter","description":"Pyeloplasty (foley y-pyeloplasty), plastic operation on renal pelvis, with or without plastic operation on ureter, nephropexy, nephrostomy, pyelostomy, or ureteral splinting; complicated (congenital kidney abnormality, secondary pyeloplasty, solitary kidney, calycoplasty)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"83498","name":"Asy hydroxyprogesterone 17-d","description":"Hydroxyprogesterone, 17-d","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4387","name":"Ost clsd pouch w att st barr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-10","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":"65175","name":"Removal of ocular implant","description":"Removal of ocular implant","date_of_service":"2026-05-10","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":"29807","name":"Sho arthrs srg rpr slap les","description":"Arthroscopy, shoulder, surgical; repair of slap lesion","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1685.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"J2940","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33516","name":"Cabg vein six or more","description":"Coronary artery bypass, vein only; 6 or more coronary venous grafts","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1821","name":"Ko elas w/ condyle pads otf","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3047.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0920","name":"Fracture frame attached to b","description":"Fracture frame, attached to bed, includes weights","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4387","name":"Ost clsd pouch w att st barr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33726","name":"Repair pul venous stenosis","description":"Repair of pulmonary venous stenosis","date_of_service":"2026-05-10","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":"L3216","name":"Orthoped ladies shoes dpth i","description":"Orthopedic footwear, ladies shoe, depth inlay, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76641","name":"Ultrasound breast complete","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete","date_of_service":"2026-05-10","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":"78075","name":"Adrenal cortex & medulla img","description":"Adrenal imaging, cortex and/or medulla","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44625","name":"Repair bowel opening","description":"Closure of enterostomy, large or small intestine; with resection and anastomosis other than colorectal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32855","name":"Prepare donor lung single","description":"Backbench standard preparation of cadaver donor lung allograft prior to transplantation, including dissection of allograft from surrounding soft tissues to prepare pulmonary venous/atrial cuff, pulmonary artery, and bronchus; unilateral","date_of_service":"2026-05-10","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":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A7507","name":"Integrated filter & holder","description":"Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77763","name":"Apply intrcav radiat compl","description":"Intracavitary radiation source application; complex","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43020","name":"Incision of esophagus","description":"Esophagotomy, cervical approach, with removal of foreign body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"21494","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"77615","name":"Hyperthermia ntrstl prb>5","description":"Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1305.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":886.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1335.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57308","name":"Fistula repair transperine","description":"Closure of rectovaginal fistula; transperineal approach, with perineal body reconstruction, with or without levator plication","date_of_service":"2026-05-10","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":"46255","name":"Remove int/ext hem 1 group","description":"Hemorrhoidectomy, internal and external, single column/group;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"44140","name":"Partial removal of colon","description":"Colectomy, partial; with anastomosis","date_of_service":"2026-05-10","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":"76100","name":"X-ray exam of body section","description":"Radiologic examination, single plane body section (eg, tomography), other than with urography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"89100","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"15845","name":"Skin and muscle repair face","description":"Graft for facial nerve paralysis; regional muscle transfer","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36870","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93531","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"57556","name":"Remove cervix repair bowel","description":"Excision of cervical stump, vaginal approach; with repair of enterocele","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69955","name":"Release facial nerve","description":"Total facial nerve decompression and/or repair (may include graft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1596.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55706","name":"Bx prst8 ndl sat sampling","description":"Biopsies, prostate, needle, transperineal, stereotactic template guided saturation sampling, including imaging guidance","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67800","name":"Remove eyelid lesion","description":"Excision of chalazion; single","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43312","name":"Repair esophagus and fistula","description":"Esophagoplasty (plastic repair or reconstruction), thoracic approach; with repair of tracheoesophageal fistula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1978.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86903","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73590","name":"X-ray exam of lower leg","description":"Radiologic examination; tibia and fibula, 2 views","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9245","name":"Inj melpha hydroch nos 50 mg","description":"Injection, melphalan hydrochloride, not otherwise specified, 50 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78140","name":"Red cell sequestration","description":"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00902","name":"Anes anorectal px","description":"Anesthesia for; anorectal procedure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00700","name":"Anes px upr ant abd wall nos","description":"Anesthesia for procedures on upper anterior abdominal wall; not otherwise specified","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1055.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1836.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5506","name":"Diabetic shoe w/off set heel","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44146","name":"Partial removal of colon","description":"Colectomy, partial; with coloproctostomy (low pelvic anastomosis), with colostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1949.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72128","name":"Ct chest spine w/o dye","description":"Computed tomography, thoracic spine; without contrast material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L6920","name":"Wrist disarticul switch ctrl","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57320","name":"Repair bladder-vagina lesion","description":"Closure of vesicovaginal fistula; vaginal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"76975","name":"Gi endoscopic ultrasound","description":"Gastrointestinal endoscopic ultrasound, supervision and interpretation","date_of_service":"2026-05-10","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":"46761","name":"Repair of anal sphincter","description":"Sphincteroplasty, anal, for incontinence, adult; levator muscle imbrication (park posterior anal repair)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"45905","name":"Dilation of anal sphincter","description":"Dilation of anal sphincter (separate procedure) under anesthesia other than local","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"44705","name":"Prepare fecal microbiota","description":"Preparation of fecal microbiota for instillation, including assessment of donor specimen","date_of_service":"2026-05-10","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":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"G0389","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86140","name":"C-reactive protein","description":"C-reactive protein;","date_of_service":"2026-05-10","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":"Q0137","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"84078","name":"Assay alkaline phosphatase","description":"Phosphatase, alkaline; heat stable (total not included)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"25000","name":"Incision of tendon sheath","description":"Incision, extensor tendon sheath, wrist (eg, de quervains disease)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7308","name":"Aminolevulinic acid hcl top","description":"Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28304","name":"Incision of midfoot bones","description":"Osteotomy, tarsal bones, other than calcaneus or talus;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":728.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"72275","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29200","name":"Strapping thorax","description":"Strapping; thorax","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"L7401","name":"Add ue prost a/e ultlite mat","description":"Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82088","name":"Assay of aldosterone","description":"Aldosterone","date_of_service":"2026-05-10","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":"81284","name":"Fxn gene detc abnor alleles","description":"Fxn (frataxin) (eg, friedreich ataxia) gene analysis; evaluation to detect abnormal (expanded) alleles","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1152.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26755","name":"Treat finger fracture each","description":"Closed treatment of distal phalangeal fracture, finger or thumb; with manipulation, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1328.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94750","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1648.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70220","name":"X-ray exam of sinuses","description":"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82175","name":"Assay of arsenic","description":"Arsenic","date_of_service":"2026-05-10","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":"75842","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28050","name":"Biopsy of foot joint lining","description":"Arthrotomy with biopsy; intertarsal or tarsometatarsal joint","date_of_service":"2026-05-10","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":"89331","name":"Retrograde ejaculation anal","description":"Sperm evaluation, for retrograde ejaculation, urine (sperm concentration, motility, and morphology, as indicated)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"90849","name":"Multiple family group psytx","description":"Multiple-family group psychotherapy","date_of_service":"2026-05-10","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":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"83065","name":"Hemoglobin thermolabile","description":"Hemoglobin; thermolabile","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"77777","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50630","name":"Removal of ureter stone","description":"Ureterolithotomy; lower one-third of ureter","date_of_service":"2026-05-10","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":"E1825","name":"Adjust finger ext & flex dev","description":"Dynamic adjustable finger extension and flexion device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"G0364","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3972","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0102","name":"Prostate ca screening; dre","description":"Prostate cancer screening; digital rectal examination","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3972","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6975","name":"Interscap-thor myoelectronic","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"15950","name":"Exc trchntr pr ulc prim sutr","description":"Excision, trochanteric pressure ulcer, with primary suture;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":"74247","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-10","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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"75801","name":"Lymph vessel x-ray arm/leg","description":"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"49062","name":"Drain to peritoneal cavity","description":"Drainage of extraperitoneal lymphocele to peritoneal cavity, open","date_of_service":"2026-05-10","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":"88365","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; initial single probe stain procedure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"61332","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01966","name":"Anes induced abortion px","description":"Anesthesia for induced abortion procedures","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2065.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"J9025","name":"Azacitidine injection","description":"Injection, azacitidine, 1 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27500","name":"Treatment of thigh fracture","description":"Closed treatment of femoral shaft fracture, without manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"87169","name":"Macroscopic exam parasite","description":"Macroscopic examination; parasite","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","date_of_service":"2026-05-10","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":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77261","name":"Ther radiology tx plng smpl","description":"Therapeutic radiology treatment planning; simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"27050","name":"Biopsy of sacroiliac joint","description":"Arthrotomy, with biopsy; sacroiliac joint","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"72190","name":"X-ray exam of pelvis","description":"Radiologic examination, pelvis; complete, minimum of 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28293","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2311","name":"Lens sphc trifo 7.25-12/.25-","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"60500","name":"Explore parathyroid glands","description":"Parathyroidectomy or exploration of parathyroid(s);","date_of_service":"2026-05-10","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":"78003","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["TC"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"71100","name":"X-ray exam ribs uni 2 views","description":"Radiologic examination, ribs, unilateral; 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84155","name":"Assay of protein serum","description":"Protein, total, except by refractometry; serum, plasma or whole blood","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87250","name":"Virus inoculate eggs/animal","description":"Virus isolation; inoculation of embryonated eggs, or small animal, includes observation and dissection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0250","name":"Hosp bed fixed ht w/ mattres","description":"Hospital bed, fixed height, with any type side rails, with mattress","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1550.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","KM","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0571","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":662.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1488.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4235","name":"Lithium batt for glucose mon","description":"Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-10","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":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"58673","name":"Laparoscopy salpingostomy","description":"Laparoscopy, surgical; with salpingostomy (salpingoneostomy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":512.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31610","name":"Tracheostomy fenest skin flp","description":"Tracheostomy, fenestration procedure with skin flaps","date_of_service":"2026-05-10","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":"63200","name":"Release spinal cord lumbar","description":"Laminectomy, with release of tethered spinal cord, lumbar","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1990","name":"Afo doub solid stirrup calf","description":"Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar bk orthosis), custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"44125","name":"Removal of small intestine","description":"Enterectomy, resection of small intestine; with enterostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73510","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"J1410","name":"Inj estrogen conjugate 25 mg","description":"Injection, estrogen conjugated, per 25 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67921","name":"Repair eyelid defect","description":"Repair of entropion; suture","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2103","name":"Spherocylindr 4.00d/12-2.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"92226","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"38240","name":"Transplt allo hct/donor","description":"Hematopoietic progenitor cell (hpc); allogeneic transplantation per donor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46257","name":"Remove in/ex hem grp & fiss","description":"Hemorrhoidectomy, internal and external, single column/group; with fissurectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5535","name":"Prep bk ptb open end socket","description":"Preparatory, below knee ptb type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1526.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86431","name":"Rheumatoid factor quant","description":"Rheumatoid factor; quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.64,"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":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15171","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"53010","name":"Incision of urethra","description":"Urethrotomy or urethrostomy, external (separate procedure); perineal urethra, external","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88271","name":"Cytogenetics dna probe","description":"Molecular cytogenetics; dna probe, each (eg, fish)","date_of_service":"2026-05-10","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":"94690","name":"O2 uptk rest indirect","description":"Oxygen uptake, expired gas analysis; rest, indirect (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77763","name":"Apply intrcav radiat compl","description":"Intracavitary radiation source application; complex","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":587.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78315","name":"Bone imaging 3 phase","description":"Bone and/or joint imaging; 3 phase study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"16035","name":"Escharotomy 1st incision","description":"Escharotomy; initial incision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46070","name":"Incision anal septum infant","description":"Incision, anal septum (infant)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1545.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1285.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70160","name":"X-ray exam of nasal bones","description":"Radiologic examination, nasal bones, complete, minimum of 3 views","date_of_service":"2026-05-10","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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"31240","name":"Nsl/sns ndsc cnch bull rescj","description":"Nasal/sinus endoscopy, surgical; with concha bullosa resection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58561","name":"Hysteroscopy remove myoma","description":"Hysteroscopy, surgical; with removal of leiomyomata","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"77052","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E0920","name":"Fracture frame attached to b","description":"Fracture frame, attached to bed, includes weights","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15360","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"36468","name":"Njx sclrsnt spider veins","description":"Injection(s) of sclerosant for spider veins (telangiectasia), limb or trunk","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88153","name":"Cytopath c/v redo","description":"Cytopathology, slides, cervical or vaginal; with manual screening and rescreening under physician supervision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75964","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0945","name":"Brompheniramine maleate inj","description":"Injection, brompheniramine maleate, per 10 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15836","name":"Exc excessive skin arm","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); arm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":789.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0610","name":"Pacemaker monitr audible/vis","description":"Pacemaker monitor, self-contained, (checks battery depletion, includes audible and visible check systems)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","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":"L6629","name":"Lamination collar w/ couplin","description":"Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal","date_of_service":"2026-05-10","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":"95010","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82528","name":"Assay of corticosterone","description":"Corticosterone","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5420","name":"Postop dsg & 1 cast chg ak/d","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change ak or knee disarticulation","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6721","name":"Hook/hand, hvy dty, vol open","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25680","name":"Cltx trns-scphprlnr fx mnpj","description":"Closed treatment of trans-scaphoperilunar type of fracture dislocation, with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71130","name":"X-ray strenoclavic jt 3/>vws","description":"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views","date_of_service":"2026-05-10","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":"80194","name":"Assay of quinidine","description":"Quinidine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2126","name":"Kafo fem fx cast thermoplas","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87158","name":"Culture typing added method","description":"Culture, typing; other methods","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"50125","name":"Pyelotomy w/drg pyelostomy","description":"Pyelotomy; with drainage, pyelostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1093.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72240","name":"Myelography neck spine","description":"Myelography, cervical, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"27486","name":"Revise/replace knee joint","description":"Revision of total knee arthroplasty, with or without allograft; 1 component","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58294","name":"Vag hyst w/enterocele compl","description":"Vaginal hysterectomy, for uterus greater than 250 g; with repair of enterocele","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75625","name":"Contrast exam abdominl aorta","description":"Aortography, abdominal, by serialography, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87290","name":"Varicella zoster ag if","description":"Infectious agent antigen detection by immunofluorescent technique; varicella zoster virus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"74360","name":"X-ray guide gi dilation","description":"Intraluminal dilation of strictures and/or obstructions (eg, esophagus), radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1751.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83655","name":"Assay of lead","description":"Lead","date_of_service":"2026-05-10","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":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"51703","name":"Insert bladder cath complex","description":"Insertion of temporary indwelling bladder catheter; complicated (eg, altered anatomy, fractured catheter/balloon)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["BA","KG","RR"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR","KF",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21120","name":"Genioplasty augmentation","description":"Genioplasty; augmentation (autograft, allograft, prosthetic material)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87003","name":"Small animal inoculation","description":"Animal inoculation, small animal, with observation and dissection","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"0548T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0492","name":"Tlso 3 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in th","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49203","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"37500","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33425","name":"Repair of mitral valve","description":"Valvuloplasty, mitral valve, with cardiopulmonary bypass;","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","date_of_service":"2026-05-10","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":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":557.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00754","name":"Anes hrna rpr omphalocele","description":"Anesthesia for hernia repairs in upper abdomen; omphalocele","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"00450","name":"Anes px clav&scapula nos","description":"Anesthesia for procedures on clavicle and scapula; not otherwise specified","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77421","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"92584","name":"Electrocochleography","description":"Electrocochleography","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-10","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":"24345","name":"Repr elbw med ligmnt w/tissu","description":"Repair medial collateral ligament, elbow, with local tissue","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42725","name":"I&d absc phrngl xtrnl appr","description":"Incision and drainage abscess; retropharyngeal or parapharyngeal, external approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":889.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86140","name":"C-reactive protein","description":"C-reactive protein;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50393","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G6023","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86480","name":"Tb test cell immun measure","description":"Tuberculosis test, cell mediated immunity antigen response measurement; gamma interferon","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"43267","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"90828","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"J1710","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"83010","name":"Assay of haptoglobin quant","description":"Haptoglobin; quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"72052","name":"X-ray exam neck spine 6/>vws","description":"Radiologic examination, spine, cervical; 6 or more views","date_of_service":"2026-05-10","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":"91022","name":"Duodenal motility study","description":"Duodenal motility (manometric) study","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":980.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28340","name":"Resect enlarged toe tissue","description":"Reconstruction, toe, macrodactyly; soft tissue resection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.6,"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":"A4423","name":"Ost pch for bar w lk fl/fltr","description":"Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each","date_of_service":"2026-05-10","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":"31820","name":"Closure of windpipe lesion","description":"Surgical closure tracheostomy or fistula; without plastic repair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"31200","name":"Removal of ethmoid sinus","description":"Ethmoidectomy; intranasal, anterior","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43325","name":"Revise esophagus & stomach","description":"Esophagogastric fundoplasty, with fundic patch (thal-nissen procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29848","name":"Wrist endoscopy/surgery","description":"Endoscopy, wrist, surgical, with release of transverse carpal ligament","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1558.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-10","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":"37618","name":"Ligation major artery xtr","description":"Ligation, major artery (eg, post-traumatic, rupture); extremity","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1643.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86332","name":"Immune complex assay","description":"Immune complex assay","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59136","name":"Treat ectopic pregnancy","description":"Surgical treatment of ectopic pregnancy; interstitial, uterine pregnancy with partial resection of uterus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","date_of_service":"2026-05-10","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":"38792","name":"Ra tracer id of sentinl node","description":"Injection procedure; radioactive tracer for identification of sentinel node","date_of_service":"2026-05-10","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":"34802","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1544.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78278","name":"Acute gi blood loss imaging","description":"Acute gastrointestinal blood loss imaging","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70491","name":"Ct soft tissue neck w/dye","description":"Computed tomography, soft tissue neck; with contrast material(s)","date_of_service":"2026-05-10","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":"76102","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27652","name":"Repair/graft achilles tendon","description":"Repair, primary, open or percutaneous, ruptured achilles tendon; with graft (includes obtaining graft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26531","name":"Revise knuckle with implant","description":"Arthroplasty, metacarpophalangeal joint; with prosthetic implant, each joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2937.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41827","name":"Excision of gum lesion","description":"Excision of lesion or tumor (except listed above), dentoalveolar structures; with complex repair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"0151T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"43268","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":946.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5616","name":"Ak univ multiplex sys frict","description":"Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"58540","name":"Revision of uterus","description":"Hysteroplasty, repair of uterine anomaly (strassman type)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67916","name":"Repair eyelid defect","description":"Repair of ectropion; excision tarsal wedge","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28171","name":"Resect tarsal tumor","description":"Radical resection of tumor; tarsal (except talus or calcaneus)","date_of_service":"2026-05-10","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":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-05-10","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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"69000","name":"Drg xtrnl ear absc/hem smpl","description":"Drainage external ear, abscess or hematoma; simple","date_of_service":"2026-05-10","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":"74150","name":"Ct abdomen w/o contrast","description":"Computed tomography, abdomen; without contrast material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93930","name":"Upper extremity study","description":"Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27652","name":"Repair/graft achilles tendon","description":"Repair, primary, open or percutaneous, ruptured achilles tendon; with graft (includes obtaining graft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"26755","name":"Treat finger fracture each","description":"Closed treatment of distal phalangeal fracture, finger or thumb; with manipulation, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-10","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":"0171T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2473.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1773.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2769.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35694","name":"Art trnsposj subclav carotid","description":"Transposition and/or reimplantation; subclavian to carotid artery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"34502","name":"Reconstruct vena cava","description":"Reconstruction of vena cava, any method","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95943","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31603","name":"Emer tracheostomy ttrach","description":"Tracheostomy, emergency procedure; transtracheal","date_of_service":"2026-05-10","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":"19306","name":"Mast rad urban type","description":"Mastectomy, radical, including pectoral muscles, axillary and internal mammary lymph nodes (urban type operation)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":809.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":364.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93660","name":"Tilt table evaluation","description":"Evaluation of cardiovascular function with tilt table evaluation, with continuous ecg monitoring and intermittent blood pressure monitoring, with or without pharmacological intervention","date_of_service":"2026-05-10","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":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70373","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73020","name":"X-ray exam of shoulder","description":"Radiologic examination, shoulder; 1 view","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28010","name":"Incision of toe tendon","description":"Tenotomy, percutaneous, toe; single tendon","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6380","name":"Postop dsg cast chg wrst/elb","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":"28730","name":"Fusion of foot bones","description":"Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"64834","name":"Repair of hand or foot nerve","description":"Suture of 1 nerve; hand or foot, common sensory nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75791","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89130","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61541","name":"Incision of brain tissue","description":"Craniotomy with elevation of bone flap; for transection of corpus callosum","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61680","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; supratentorial, simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":674.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L3204","name":"Hightop w/ supp/pronator inf","description":"Orthopedic shoe, hightop with supinator or pronator, infant","date_of_service":"2026-05-10","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":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"22522","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"J1540","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78262","name":"Gastroesophageal reflux std","description":"Gastroesophageal reflux study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69005","name":"Drg xtrnl ear absc/hem comp","description":"Drainage external ear, abscess or hematoma; complicated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"93600","name":"Bundle of his recording","description":"Bundle of his recording","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1087","name":"Wheelchair lightwt fixed arm","description":"High strength lightweight wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71030","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"L1852","name":"Ko double upright prefab ots","description":"Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-10","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":"01404","name":"Anes opn/arthrs disrtcj knee","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; disarticulation at knee","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"J2460","name":"Oxytetracycline injection","description":"Injection, oxytetracycline hcl, up to 50 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00222","name":"Anes icr px ecoag icr nrv","description":"Anesthesia for intracranial procedures; electrocoagulation of intracranial nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82693","name":"Assay of ethylene glycol","description":"Ethylene glycol","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A6234","name":"Hydrocolld drg <=16 w/o bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33967","name":"Insert i-aort percut device","description":"Insertion of intra-aortic balloon assist device, percutaneous","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73592","name":"X-ray exam of leg infant","description":"Radiologic examination; lower extremity, infant, minimum of 2 views","date_of_service":"2026-05-10","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":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"72255","name":"Myelography thoracic spine","description":"Myelography, thoracic, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92507","name":"Tx sp lang voice comm indiv","description":"Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"85370","name":"Fibrinogen test","description":"Fibrin(ogen) degradation (split) products (fdp) (fsp); quantitative","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00218","name":"Anes icr px in sitting pos","description":"Anesthesia for intracranial procedures; procedures in sitting position","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33884","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"22214","name":"Incis 1 vertebral seg lumbar","description":"Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; lumbar","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"93603","name":"Right ventricular recording","description":"Right ventricular recording","date_of_service":"2026-05-10","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":"A4663","name":"Dialysis blood pressure cuff","description":"Blood pressure cuff only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93652","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"64736","name":"Incision of chin nerve","description":"Transection or avulsion of; mental nerve","date_of_service":"2026-05-10","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":"83631","name":"Lactoferrin fecal (quant)","description":"Lactoferrin, fecal; quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"72202","name":"X-ray exam si joints 3/> vws","description":"Radiologic examination, sacroiliac joints; 3 or more views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95910","name":"Nrv cndj test 7-8 studies","description":"Nerve conduction studies; 7-8 studies","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2526","name":"Th/wght bear nar m-l brim cu","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35634","name":"Bpg iliorenal","description":"Bypass graft, with other than vein; iliorenal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"86710","name":"Influenza virus antibody","description":"Antibody; influenza virus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"65220","name":"Remove foreign body from eye","description":"Removal of foreign body, external eye; corneal, without slit lamp","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KF"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"54670","name":"Repair testis injury","description":"Suture or repair of testicular injury","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75605","name":"Contrast exam thoracic aorta","description":"Aortography, thoracic, by serialography, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78478","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"26499","name":"Correction claw finger other","description":"Correction claw finger, other methods","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"61613","name":"Remove aneurysm sinus","description":"Obliteration of carotid aneurysm, arteriovenous malformation, or carotid-cavernous fistula by dissection within cavernous sinus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3017.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69220","name":"Clean out mastoid cavity","description":"Debridement, mastoidectomy cavity, simple (eg, routine cleaning)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78000","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-10","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":"95910","name":"Nrv cndj test 7-8 studies","description":"Nerve conduction studies; 7-8 studies","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["26"]}],"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":"2026-05-10","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":"77280","name":"Ther rad simulaj field smpl","description":"Therapeutic radiology simulation-aided field setting; simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":"00100","name":"Anes px salivary gland w/bx","description":"Anesthesia for procedures on salivary glands, including biopsy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"20926","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32800","name":"Repair lung hernia","description":"Repair lung hernia through chest wall","date_of_service":"2026-05-10","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":"87205","name":"Smear gram stain","description":"Smear, primary source with interpretation; gram or giemsa stain for bacteria, fungi, or cell types","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"68525","name":"Biopsy of tear sac","description":"Biopsy of lacrimal sac","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":"67420","name":"Explore/treat eye socket","description":"Orbitotomy with bone flap or window, lateral approach (eg, kroenlein); with removal of lesion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1721.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2008.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KC"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"35363","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; combined aortoiliofemoral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":840.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76940","name":"Us guide tissue ablation","description":"Ultrasound guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97039","name":"Unlisted modality","description":"Unlisted modality (specify type and time if constant attendance)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74710","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83721","name":"Assay of blood lipoprotein","description":"Lipoprotein, direct measurement; ldl cholesterol","date_of_service":"2026-05-10","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":"82705","name":"Fats/lipids feces qual","description":"Fat or lipids, feces; qualitative","date_of_service":"2026-05-10","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":"E0171","name":"Commode chair non-electric","description":"Commode chair with integrated seat lift mechanism, non-electric, any type","date_of_service":"2026-05-10","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":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":"L2040","name":"Hkafo torsion bil rot straps","description":"Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78466","name":"Heart infarct image","description":"Myocardial imaging, infarct avid, planar; qualitative or quantitative","date_of_service":"2026-05-10","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":"71015","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"86039","name":"Antinuclear antibodies (ana)","description":"Antinuclear antibodies (ana); titer","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27193","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":530.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"24420","name":"Osteoplasty humerus","description":"Osteoplasty, humerus (eg, shortening or lengthening) (excluding 64876)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0239","name":"Hydrocollator unit portable","description":"Hydrocollator unit, portable","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"74410","name":"Urography nfs drip&/bolus","description":"Urography, infusion, drip technique and/or bolus technique;","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36510","name":"Insertion of catheter vein","description":"Catheterization of umbilical vein for diagnosis or therapy, newborn","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1147.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3962","name":"Sewho erbs palsey design abd","description":"Shoulder elbow wrist hand orthosis, abduction positioning, erbs palsey design, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9000","name":"Doxorubicin hcl injection","description":"Injection, doxorubicin hydrochloride, 10 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"15786","name":"Abrasion lesion single","description":"Abrasion; single lesion (eg, keratosis, scar)","date_of_service":"2026-05-10","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":"77263","name":"Ther radiology tx plng cplx","description":"Therapeutic radiology treatment planning; complex","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6586","name":"Elbow fair lead cable dir fo","description":"Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"38242","name":"Transplt allo lymphocytes","description":"Allogeneic lymphocyte infusions","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"77074","name":"Radex osseous survey lmtd","description":"Radiologic examination, osseous survey; limited (eg, for metastases)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"88245","name":"Chromosome analysis 20-25","description":"Chromosome analysis for breakage syndromes; baseline sister chromatid exchange (sce), 20-25 cells","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3765","name":"Ewhfo rigid w/o jnts cf","description":"Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00754","name":"Anes hrna rpr omphalocele","description":"Anesthesia for hernia repairs in upper abdomen; omphalocele","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"46230","name":"Removal of anal tags","description":"Excision of multiple external papillae or tags, anus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"77620","name":"Hyperthermia gen intrcv prb","description":"Hyperthermia generated by intracavitary probe(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83987","name":"Exhaled breath condensate","description":"Ph; exhaled breath condensate","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78000","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1812","name":"Knee ext/flex w act res ctrl","description":"Dynamic knee, extension/flexion device with active resistance control","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77333","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; intermediate (multiple blocks, stents, bite blocks, special bolus)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"59430","name":"Care after delivery","description":"Postpartum care only (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"51741","name":"Electro-uroflowmetry first","description":"Complex uroflowmetry (eg, calibrated electronic equipment)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3049.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4305","name":"Drug delivery system >=50 ml","description":"Disposable drug delivery system, flow rate of 50 ml or greater per hour","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"B4168","name":"Parenteral sol amino acid 3.","description":"Parenteral nutrition solution; amino acid, 3.5%, (500 ml = 1 unit) - home mix","date_of_service":"2026-05-10","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":"V2210","name":"Lens sphcy bifocal 4.25-7/ov","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"21385","name":"Opn tx orbit fx transantral","description":"Open treatment of orbital floor blowout fracture; transantral approach (caldwell-luc type operation)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1690","name":"Combination bilateral ho","description":"Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":"0232T","name":"Njx platelet plasma","description":"Injection(s), platelet rich plasma, any site, including image guidance, harvesting and preparation when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45380","name":"Colonoscopy and biopsy","description":"Colonoscopy, flexible; with biopsy, single or multiple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"83903","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0783","name":"Programmable infusion pump","description":"Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-05-10","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":"35508","name":"Art byp grft carotid-vertbrl","description":"Bypass graft, with vein; carotid-vertebral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1392.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"53250","name":"Removal of urethra gland","description":"Excision of bulbourethral gland (cowpers gland)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"78650","name":"Csf leakage imaging","description":"Cerebrospinal fluid leakage detection and localization","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"73540","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5814","name":"Endo knee-shin hydral swg ph","description":"Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1223","name":"Wheelchair spec size w foot","description":"Wheelchair with detachable arms, footrests","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["TC"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":599.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"84443","name":"Assay thyroid stim hormone","description":"Thyroid stimulating hormone (tsh)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77421","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29807","name":"Sho arthrs srg rpr slap les","description":"Arthroscopy, shoulder, surgical; repair of slap lesion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1244.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-10","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":"88311","name":"Decalcify tissue","description":"Decalcification procedure (list separately in addition to code for surgical pathology examination)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84460","name":"Alanine amino (alt) (sgpt)","description":"Transferase; alanine amino (alt) (sgpt)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00140","name":"Anes procedures on eye nos","description":"Anesthesia for procedures on eye; not otherwise specified","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"20816","name":"Replantation digit complete","description":"Replantation, digit, excluding thumb (includes metacarpophalangeal joint to insertion of flexor sublimis tendon), complete amputation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3357.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"97150","name":"Group therapeutic procedures","description":"Therapeutic procedure(s), group (2 or more individuals)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1034.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44150","name":"Removal of colon","description":"Colectomy, total, abdominal, without proctectomy; with ileostomy or ileoproctostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47721","name":"Fuse upper gi structures","description":"Cholecystoenterostomy; with gastroenterostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1135.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":946.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6722","name":"Hook/hand, hvy dty, vol clos","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83950","name":"Oncoprotein her-2/neu","description":"Oncoprotein; her-2/neu","date_of_service":"2026-05-10","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":"88164","name":"Cytopath tbs c/v manual","description":"Cytopathology, slides, cervical or vaginal (the bethesda system); manual screening under physician supervision","date_of_service":"2026-05-10","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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","date_of_service":"2026-05-10","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":"27248","name":"Treat thigh fracture","description":"Open treatment of greater trochanteric fracture, includes internal fixation, when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":933.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00190","name":"Anes px facial b1/skull nos","description":"Anesthesia for procedures on facial bones or skull; not otherwise specified","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84545","name":"Urea-n clearance test","description":"Urea nitrogen, clearance","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1805","name":"Adjust wrist ext & flex dev","description":"Dynamic adjustable wrist extension and flexion device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"0498T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"E1050","name":"Whelchr fxd full length arms","description":"Fully-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-05-10","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":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15829","name":"Rhytidectomy smas flap","description":"Rhytidectomy; superficial musculoaponeurotic system (smas) flap","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6211","name":"Foam drg > 48 sq in w/o brdr","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"25560","name":"Cltx rdl&uln shft fx wo mnpj","description":"Closed treatment of radial and ulnar shaft fractures; without manipulation","date_of_service":"2026-05-10","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":"L7406","name":"Add upp ext mec limb vol lam","description":"Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5102","name":"Bedside drain btl w/wo tube","description":"Bedside drainage bottle with or without tubing, rigid or expandable, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46050","name":"I&d perianal abscess supfc","description":"Incision and drainage, perianal abscess, superficial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27448","name":"Incision of thigh","description":"Osteotomy, femur, shaft or supracondylar; without fixation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58957","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","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":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0585","name":"Nebulizer w/ compressor & he","description":"Nebulizer, with compressor and heater","date_of_service":"2026-05-10","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":"76705","name":"Echo exam of abdomen","description":"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1920","name":"Afo sing upright w/ adjust s","description":"Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0106","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75840","name":"Vein x-ray adrenal gland","description":"Venography, adrenal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"69711","name":"Remove/repair hearing aid","description":"Removal or repair of electromagnetic bone conduction hearing device in temporal bone","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"78007","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"ATP04","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"01756","name":"Anes opn/arthrs elbw rad px","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; radical procedures","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"A4261","name":"Cervical cap contraceptive","description":"Cervical cap for contraceptive use","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","date_of_service":"2026-05-10","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":"74440","name":"X-ray male genital tract","description":"Vasography, vesiculography, or epididymography, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"97022","name":"Whirlpool therapy","description":"Application of a modality to 1 or more areas; whirlpool","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"10081","name":"I&d pilonidal cyst comp","description":"Incision and drainage of pilonidal cyst; complicated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82140","name":"Assay of ammonia","description":"Ammonia","date_of_service":"2026-05-10","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":"00635","name":"Anes dx/ther lumbar pnxr","description":"Anesthesia for procedures in lumbar region; diagnostic or therapeutic lumbar puncture","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1209.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1846","name":"Ko w adj flex/ext rotat mold","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33960","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38240","name":"Transplt allo hct/donor","description":"Hematopoietic progenitor cell (hpc); allogeneic transplantation per donor","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"24930","name":"Amputation follow-up surgery","description":"Amputation, arm through humerus; re-amputation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3320","name":"Shoe lift elev heel/sole cor","description":"Lift, elevation, heel and sole, cork, per inch","date_of_service":"2026-05-10","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":"86717","name":"Leishmania antibody","description":"Antibody; leishmania","date_of_service":"2026-05-10","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":"31584","name":"Laryngoplasty fx rdctj fixj","description":"Laryngoplasty; with open reduction and fixation of (eg, plating) fracture, includes tracheostomy, if performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1773.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1303.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"15842","name":"Nerve palsy microsurg graft","description":"Graft for facial nerve paralysis; free muscle flap by microsurgical technique","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2952.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"50688","name":"Change of ureter tube/stent","description":"Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57305","name":"Repair rectum-vagina fistula","description":"Closure of rectovaginal fistula; abdominal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":627.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2783","name":"Rasburicase","description":"Injection, rasburicase, 0.5 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61320","name":"Crnec/crnot drg icr abs sttl","description":"Craniectomy or craniotomy, drainage of intracranial abscess; supratentorial","date_of_service":"2026-05-10","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":"75982","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"11719","name":"Trim nail(s) any number","description":"Trimming of nondystrophic nails, any number","date_of_service":"2026-05-10","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":"90619","name":"Menacwy-tt vaccine im","description":"Meningococcal conjugate vaccine, serogroups a, c, w, y, quadrivalent, tetanus toxoid carrier (menacwy-tt), for intramuscular use","date_of_service":"2026-05-10","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":201.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"51792","name":"Urinary reflex study","description":"Stimulus evoked response (eg, measurement of bulbocavernosus reflex latency time)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"85230","name":"Clot factor vii proconvertin","description":"Clotting; factor vii (proconvertin, stable factor)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"74455","name":"X-ray urethra/bladder","description":"Urethrocystography, voiding, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4433","name":"Urine ost pch bar w lock fln","description":"Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"87804","name":"Influenza assay w/optic","description":"Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; influenza","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24342","name":"Repair of ruptured tendon","description":"Reinsertion of ruptured biceps or triceps tendon, distal, with or without tendon graft","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62000","name":"Treat skull fracture","description":"Elevation of depressed skull fracture; simple, extradural","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00174","name":"Anes ntrorl exc rtrphrng tum","description":"Anesthesia for intraoral procedures, including biopsy; excision of retropharyngeal tumor","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E0464","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35454","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":464.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1630","name":"Abduct control hip semi-flex","description":"Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52265","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with dilation of bladder for interstitial cystitis; local anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1432.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41823","name":"Excision of gum lesion","description":"Excision of osseous tuberosities, dentoalveolar structures","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33322","name":"Repair major blood vessel(s)","description":"Suture repair of aorta or great vessels; with cardiopulmonary bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1513.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","date_of_service":"2026-05-10","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":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"38745","name":"Remove armpit lymph nodes","description":"Axillary lymphadenectomy; complete","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"84466","name":"Assay of transferrin","description":"Transferrin","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0366","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27704","name":"Removal of ankle implant","description":"Removal of ankle implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28290","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75820","name":"Vein x-ray arm/leg","description":"Venography, extremity, unilateral, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"21335","name":"Open tx nose & septal fx","description":"Open treatment of nasal fracture; with concomitant open treatment of fractured septum","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":857.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","date_of_service":"2026-05-10","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":"00730","name":"Anes px upper pst abdl wall","description":"Anesthesia for procedures on upper posterior abdominal wall","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5102","name":"Bedside drain btl w/wo tube","description":"Bedside drainage bottle with or without tubing, rigid or expandable, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1391.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A9901","name":"Delivery/set up/dispensing","description":"Dme delivery, set up, and/or dispensing service component of another hcpcs code","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["TC"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28576","name":"Treat foot dislocation","description":"Percutaneous skeletal fixation of talotarsal joint dislocation, with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86694","name":"Herpes simplex nes antbdy","description":"Antibody; herpes simplex, non-specific type test","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99462","name":"Sbsq nb em per day hosp","description":"Subsequent hospital care, per day, for evaluation and management of normal newborn","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9955","name":"Inj perflexane lip micros,ml","description":"Injection, perflexane lipid microspheres, per ml","date_of_service":"2026-05-10","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":"26850","name":"Fusion of knuckle","description":"Arthrodesis, metacarpophalangeal joint, with or without internal fixation;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":935.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"90809","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31612","name":"Perq trchl pnxr ttrach aspir","description":"Tracheal puncture, percutaneous with transtracheal aspiration and/or injection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58563","name":"Hysteroscopy ablation","description":"Hysteroscopy, surgical; with endometrial ablation (eg, endometrial resection, electrosurgical ablation, thermoablation)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68720","name":"Create tear sac drain","description":"Dacryocystorhinostomy (fistulization of lacrimal sac to nasal cavity)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0980","name":"Peroneal straps pair pre ots","description":"Peroneal straps, prefabricated, off-the-shelf, pair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1233.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76821","name":"Middle cerebral artery echo","description":"Doppler velocimetry, fetal; middle cerebral artery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"23440","name":"Remove/transplant tendon","description":"Resection or transplantation of long tendon of biceps","date_of_service":"2026-05-10","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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4408","name":"Ext wear ost skn barr >4sqin","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-10","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":"78605","name":"Brain image 4+ views","description":"Brain imaging, minimum 4 static views;","date_of_service":"2026-05-10","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":"L2036","name":"Kafo plas doub free knee mol","description":"Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1152.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1560.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":831.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"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":"2026-05-10","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":"67908","name":"Repair eyelid defect","description":"Repair of blepharoptosis; conjunctivo-tarso-mullers muscle-levator resection (eg, fasanella-servat type)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":481.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1972.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1182.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1120.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"28130","name":"Removal of ankle bone","description":"Talectomy (astragalectomy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":731.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47120","name":"Partial removal of liver","description":"Hepatectomy, resection of liver; partial lobectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2457.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"64763","name":"Incise hip/thigh nerve","description":"Transection or avulsion of obturator nerve, extrapelvic, with or without adductor tenotomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21244","name":"Reconstruction of lower jaw","description":"Reconstruction of mandible, extraoral, with transosteal bone plate (eg, mandibular staple bone plate)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49590","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0628","name":"Lso flex no ri stays pre ots","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1812","name":"Knee ext/flex w act res ctrl","description":"Dynamic knee, extension/flexion device with active resistance control","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"32900","name":"Removal of rib(s)","description":"Resection of ribs, extrapleural, all stages","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1482.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"33977","name":"Remove ventricular device","description":"Removal of ventricular assist device; extracorporeal, single ventricle","date_of_service":"2026-05-10","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":"64623","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84703","name":"Chorionic gonadotropin assay","description":"Gonadotropin, chorionic (hcg); qualitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6441","name":"Pad band w>=3in <5in/yd","description":"Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"83906","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"26517","name":"Fusion of knuckle joints","description":"Capsulodesis, metacarpophalangeal joint; 2 digits","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1096.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"75650","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-10","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":"69710","name":"Implant/replace hearing aid","description":"Implantation or replacement of electromagnetic bone conduction hearing device in temporal bone","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27194","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"50234","name":"Removal of kidney & ureter","description":"Nephrectomy with total ureterectomy and bladder cuff; through same incision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"35509","name":"Art byp grft contral carotid","description":"Bypass graft, with vein; carotid-contralateral carotid","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"21600","name":"Partial removal of rib","description":"Excision of rib, partial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":616.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"27326","name":"Neurectomy popliteal","description":"Neurectomy, popliteal (gastrocnemius)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"61332","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43880","name":"Closure gastrocolic fistula","description":"Closure of gastrocolic fistula","date_of_service":"2026-05-10","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":"22210","name":"Incis 1 vertebral seg cerv","description":"Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; cervical","date_of_service":"2026-05-10","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":"73650","name":"X-ray exam of heel","description":"Radiologic examination; calcaneus, minimum of 2 views","date_of_service":"2026-05-10","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":"64774","name":"Remove skin nerve lesion","description":"Excision of neuroma; cutaneous nerve, surgically identifiable","date_of_service":"2026-05-10","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":"75957","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76705","name":"Echo exam of abdomen","description":"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"86651","name":"Encephalitis californ antbdy","description":"Antibody; encephalitis, california (la crosse)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q0187","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1043.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"61711","name":"Fusion of skull arteries","description":"Anastomosis, arterial, extracranial-intracranial (eg, middle cerebral/cortical) arteries","date_of_service":"2026-05-10","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":"84702","name":"Chorionic gonadotropin test","description":"Gonadotropin, chorionic (hcg); quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1224","name":"Wheelchair spec size w/ leg","description":"Wheelchair with detachable arms, elevating legrests","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3640","name":"Shoe dennis browne splint bo","description":"Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51925","name":"Hysterectomy/bladder repair","description":"Closure of vesicouterine fistula; with hysterectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1174.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"84081","name":"Assay phosphatidylglycerol","description":"Phosphatidylglycerol","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11600","name":"Exc tr-ext mal+marg 0.5 cm/<","description":"Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 0.5 cm or less","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J3100","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2040.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"86803","name":"Hepatitis c ab test","description":"Hepatitis c antibody;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"71035","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KC"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3890","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88347","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27788","name":"Treatment of ankle fracture","description":"Closed treatment of distal fibular fracture (lateral malleolus); with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3762","name":"Eo rigid w/o joints pre ots","description":"Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-10","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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":703.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88365","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; initial single probe stain procedure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69450","name":"Eardrum revision","description":"Tympanolysis, transcanal","date_of_service":"2026-05-10","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":"86431","name":"Rheumatoid factor quant","description":"Rheumatoid factor; quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"67027","name":"Implant eye drug system","description":"Implantation of intravitreal drug delivery system (eg, ganciclovir implant), includes concomitant removal of vitreous","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":510.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5321","name":"Ak open end sach","description":"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"62273","name":"Inject epidural patch","description":"Injection, epidural, of blood or clot patch","date_of_service":"2026-05-10","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":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78130","name":"Red cell survival study","description":"Red cell survival study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67916","name":"Repair eyelid defect","description":"Repair of ectropion; excision tarsal wedge","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00908","name":"Anes perineal prostatectomy","description":"Anesthesia for; perineal prostatectomy","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3253","name":"Shoe molded plastazote cust","description":"Foot, molded shoe plastazote (or similar) custom fitted, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86787","name":"Varicella-zoster antibody","description":"Antibody; varicella-zoster","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L6621","name":"Flex/ext wrist w/wo friction","description":"Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"39561","name":"Resect diaphragm complex","description":"Resection, diaphragm; with complex repair (eg, prosthetic material, local muscle flap)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1069.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86612","name":"Blastomyces antibody","description":"Antibody; blastomyces","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":646.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"65220","name":"Remove foreign body from eye","description":"Removal of foreign body, external eye; corneal, without slit lamp","date_of_service":"2026-05-10","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":"68760","name":"Close tear duct opening","description":"Closure of the lacrimal punctum; by thermocauterization, ligation, or laser surgery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"J0882","name":"Darbepoetin alfa, esrd use","description":"Injection, darbepoetin alfa, 1 microgram (for esrd on dialysis)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86355","name":"B cells total count","description":"B cells, total count","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2637.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","date_of_service":"2026-05-10","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":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":364.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":759.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"95813","name":"Eeg extnd mntr 61-119 min","description":"Electroencephalogram (eeg) extended monitoring; 61-119 minutes","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24357","name":"Repair elbow perc","description":"Tenotomy, elbow, lateral or medial (eg, epicondylitis, tennis elbow, golfers elbow); percutaneous","date_of_service":"2026-05-10","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":"50620","name":"Removal of ureter stone","description":"Ureterolithotomy; middle one-third of ureter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":985.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"60270","name":"Removal of thyroid","description":"Thyroidectomy, including substernal thyroid; sternal split or transthoracic approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87285","name":"Treponema pallidum ag if","description":"Infectious agent antigen detection by immunofluorescent technique; treponema pallidum","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"65265","name":"Remove foreign body from eye","description":"Removal of foreign body, intraocular; from posterior segment, nonmagnetic extraction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1057.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93561","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"J0735","name":"Clonidine hydrochloride","description":"Injection, clonidine hydrochloride, 1 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J0135","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":419.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2111","name":"Spherocylindr 7.25d/.25-2.25","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"87176","name":"Tissue homogenization cultr","description":"Homogenization, tissue, for culture","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"85598","name":"Hexagnal phosph pltlt neutrl","description":"Phospholipid neutralization; hexagonal phospholipid","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"55110","name":"Explore scrotum","description":"Scrotal exploration","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88182","name":"Cell marker study","description":"Flow cytometry, cell cycle or dna analysis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"41500","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59821","name":"Treatment of miscarriage","description":"Treatment of missed abortion, completed surgically; second trimester","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1567.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","date_of_service":"2026-05-10","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":"27656","name":"Repair leg fascia defect","description":"Repair, fascial defect of leg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"1125F","name":"Amnt pain noted pain prsnt","description":"Pain severity quantified; pain present (coa) (onc)","date_of_service":"2026-05-10","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":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94662","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83069","name":"Hemoglobin urine","description":"Hemoglobin; urine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"50684","name":"Injection for ureter x-ray","description":"Injection procedure for ureterography or ureteropyelography through ureterostomy or indwelling ureteral catheter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99318","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"00920","name":"Anes px male genitalia nos","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76086","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":610.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75658","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84450","name":"Transferase (ast) (sgot)","description":"Transferase; aspartate amino (ast) (sgot)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","date_of_service":"2026-05-10","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":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6019","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":942.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0363","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4297.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6258","name":"Transparent film >16<=48 in","description":"Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-10","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":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"43401","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1544.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"64605","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20956","name":"Iliac bone graft microvasc","description":"Bone graft with microvascular anastomosis; iliac crest","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6262","name":"Wound filler dry form / gram","description":"Wound filler, dry form, per gram, not otherwise specified","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"70487","name":"Ct maxillofacial w/dye","description":"Computed tomography, maxillofacial area; with contrast material(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"32420","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"L6721","name":"Hook/hand, hvy dty, vol open","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1380.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"74475","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"C1894","name":"Intro/sheath, non-laser","description":"Introducer/sheath, other than guiding, other than intracardiac electrophysiological, non-laser","date_of_service":"2026-05-10","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":"27284","name":"Arthrodesis hip joint","description":"Arthrodesis, hip joint (including obtaining graft);","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1911.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"26440","name":"Release palm/finger tendon","description":"Tenolysis, flexor tendon; palm or finger, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1426.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6007","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33533","name":"Cabg arterial single","description":"Coronary artery bypass, using arterial graft(s); single arterial graft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2286.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5671","name":"Bk/ak locking mechanism","description":"Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0638","name":"Lso sag-coronal panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"01936","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"86821","name":"Lymphocyte culture mixed","description":"Hla typing; lymphocyte culture, mixed (mlc)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87480","name":"Candida dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); candida species, direct probe technique","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","date_of_service":"2026-05-10","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":"67850","name":"Dstrj lesion lid margin <1cm","description":"Destruction of lesion of lid margin (up to 1 cm)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"65430","name":"Corneal smear","description":"Scraping of cornea, diagnostic, for smear and/or culture","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30110","name":"Removal of nose polyp(s)","description":"Excision, nasal polyp(s), simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":392.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95943","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87118","name":"Mycobacteric identification","description":"Culture, mycobacterial, definitive identification, each isolate","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"S8428","name":"Ready gradient gauntlet","description":"Gradient pressure aid (gauntlet), ready made","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"49220","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"31420","name":"Epiglottidectomy","description":"Epiglottidectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":924.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1248.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54901","name":"Fusion of spermatic ducts","description":"Epididymovasostomy, anastomosis of epididymis to vas deferens; bilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2716.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73620","name":"X-ray exam of foot","description":"Radiologic examination, foot; 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1620","name":"Ho flex pavlik harns pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28293","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1157.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26135","name":"Revise finger joint each","description":"Synovectomy, metacarpophalangeal joint including intrinsic release and extensor hood reconstruction, each digit","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":660.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83664","name":"Lamellar bdy fetal lung","description":"Fetal lung maturity assessment; lamellar body density","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"53270","name":"Removal of urethra gland","description":"Excision or fulguration; skenes glands","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76006","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"72285","name":"Discography cerv/thor spine","description":"Discography, cervical or thoracic, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"29105","name":"Application long arm splint","description":"Application of long arm splint (shoulder to hand)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-10","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":"E1295","name":"Wheelchair heavy duty fixed","description":"Heavy duty wheelchair, fixed full length arms, elevating legrest","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1543.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2313","name":"Lens sphc trifo 7.25-12/4.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-10","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":"74249","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"78103","name":"Bone marrow imaging mult","description":"Bone marrow imaging; multiple areas","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25810","name":"Arthrd wrst iliac/oth agrft","description":"Arthrodesis, wrist; with iliac or other autograft (includes obtaining graft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1009.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"50365","name":"Rnl altrnsplj w/rcp nfrct","description":"Renal allotransplantation, implantation of graft; with recipient nephrectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2645.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26474","name":"Fusion of finger tendons","description":"Tenodesis; of distal joint, each joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":810.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L3206","name":"Hightop w/ supp/pronator chi","description":"Orthopedic shoe, hightop with supinator or pronator, child","date_of_service":"2026-05-10","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":"31087","name":"Removal of frontal sinus","description":"Sinusotomy frontal; nonobliterative, with osteoplastic flap, coronal incision","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27780","name":"Treatment of fibula fracture","description":"Closed treatment of proximal fibula or shaft fracture; without manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44820","name":"Excision of mesentery lesion","description":"Excision of lesion of mesentery (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":851.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27310","name":"Exploration of knee joint","description":"Arthrotomy, knee, with exploration, drainage, or removal of foreign body (eg, infection)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"59300","name":"Episiotomy or vaginal repair","description":"Episiotomy or vaginal repair, by other than attending","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"01360","name":"Anes open px lower 1/3 femur","description":"Anesthesia for all open procedures on lower one-third of femur","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86793","name":"Yersinia antibody","description":"Antibody; yersinia","date_of_service":"2026-05-10","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":"77777","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":659.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":695.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":752.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"36563","name":"Insert tunneled cv cath","description":"Insertion of tunneled centrally inserted central venous access device with subcutaneous pump","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23570","name":"Cltx scapular fx w/o mnpj","description":"Closed treatment of scapular fracture; without manipulation","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4331","name":"Extension drainage tubing","description":"Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["CHPHMO","EPHMO","MCRHMO","MCRPPO","MEDICAIDHMO","QHPHMO","SHP","CCHMO"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1114.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90723","name":"Dtap-hep b-ipv vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, hepatitis b, and inactivated poliovirus vaccine (dtap-hepb-ipv), for intramuscular use","date_of_service":"2026-05-10","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":126.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"26553","name":"Single transfer toe-hand","description":"Transfer, toe-to-hand with microvascular anastomosis; other than great toe, single","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3106.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86378","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35521","name":"Art byp grft axill-femoral","description":"Bypass graft, with vein; axillary-femoral","date_of_service":"2026-05-10","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":"61556","name":"Incise skull/sutures","description":"Craniotomy for craniosynostosis; frontal or parietal bone flap","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1749.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":942.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"92250","name":"Fundus photography w/i&r","description":"Fundus photography with interpretation and report","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"53620","name":"Dilate urethra stricture","description":"Dilation of urethral stricture by passage of filiform and follower, male; initial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8032","name":"Reusable nipple prosthesis","description":"Nipple prosthesis, prefabricated, reusable, any type, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":"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":"2026-05-10","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":"28290","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35473","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L4360","name":"Pneumat walking boot pre cst","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","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":"27889","name":"Ankle disarticulation","description":"Ankle disarticulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93561","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27818","name":"Treatment of ankle fracture","description":"Closed treatment of trimalleolar ankle fracture; with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0634","name":"Lso flexion control custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, c","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":971.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1174.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52320","name":"Cystoscopy and treatment","description":"Cystourethroscopy (including ureteral catheterization); with removal of ureteral calculus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1768.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1830","name":"Adjust toe ext & flex device","description":"Dynamic adjustable toe extension and flexion device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1409.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"L1815","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":646.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3908","name":"Who cock-up nonmolde pre ots","description":"Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"73600","name":"X-ray exam of ankle","description":"Radiologic examination, ankle; 2 views","date_of_service":"2026-05-10","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":"41823","name":"Excision of gum lesion","description":"Excision of osseous tuberosities, dentoalveolar structures","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1291.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":"82533","name":"Total cortisol","description":"Cortisol; total","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82252","name":"Fecal bilirubin test","description":"Bilirubin; feces, qualitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"54620","name":"Suspension of testis","description":"Fixation of contralateral testis (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25391","name":"Lengthen radius or ulna","description":"Osteoplasty, radius or ulna; lengthening with autograft","date_of_service":"2026-05-10","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":"82965","name":"Assay of gdh enzyme","description":"Glutamate dehydrogenase","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66030","name":"Injection treatment of eye","description":"Injection, anterior chamber of eye (separate procedure); medication","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"70350","name":"X-ray head for orthodontia","description":"Cephalogram, orthodontic","date_of_service":"2026-05-10","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":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77290","name":"Ther rad simulaj field cplx","description":"Therapeutic radiology simulation-aided field setting; complex","date_of_service":"2026-05-10","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":"68335","name":"Revise/graft eyelid lining","description":"Repair of symblepharon; with free graft conjunctiva or buccal mucous membrane (includes obtaining graft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":616.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83540","name":"Assay of iron","description":"Iron","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36011","name":"Place catheter in vein","description":"Selective catheter placement, venous system; first order branch (eg, renal vein, jugular vein)","date_of_service":"2026-05-10","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":"48146","name":"Pancreatectomy","description":"Pancreatectomy, distal, near-total with preservation of duodenum (child-type procedure)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8684","name":"Radiof trsmtr implt scrl neu","description":"Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":955.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6884","name":"Replc sockt above elbow disa","description":"Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power","date_of_service":"2026-05-10","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":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86308","name":"Heterophile antibody screen","description":"Heterophile antibodies; screening","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6721","name":"Hook/hand, hvy dty, vol open","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1145.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"33611","name":"Repair double ventricle","description":"Repair of double outlet right ventricle with intraventricular tunnel repair;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2334.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"23625","name":"Cltx gr hmrl tbrs fx w/mnpj","description":"Closed treatment of greater humeral tuberosity fracture; with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87533","name":"Hhv-6 dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); herpes virus-6, quantification","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22523","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"72131","name":"Ct lumbar spine w/o dye","description":"Computed tomography, lumbar spine; without contrast material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"49000","name":"Exploration of abdomen","description":"Exploratory laparotomy, exploratory celiotomy with or without biopsy(s) (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":566.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"72070","name":"X-ray exam thorac spine 2vws","description":"Radiologic examination, spine; thoracic, 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-10","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":"A4393","name":"Urine pch w ex wear bar conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"90716","name":"Var vaccine live subq","description":"Varicella virus vaccine (var), live, for subcutaneous use","date_of_service":"2026-05-10","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":218.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-10","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":"G0114","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1338.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"90697","name":"Dtap-ipv-hib-hepb vaccine im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine, inactivated poliovirus vaccine, haemophilus influenzae type b prp-omp conjugate vaccine, and hepatitis b vaccine (dtap-ipv-hib-hepb), for intramuscular use","date_of_service":"2026-05-10","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":189.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"65765","name":"Keratophakia","description":"Keratophakia","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61567","name":"Incision of brain tissue","description":"Craniotomy with elevation of bone flap; for multiple subpial transections, with electrocorticography during surgery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2854.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2310","name":"Abduction bar-straight","description":"Addition to lower extremity, abduction bar-straight","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"J9264","name":"Paclitaxel protein bound","description":"Injection, paclitaxel protein-bound particles, 1 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54200","name":"Injection px peyronie ds","description":"Injection procedure for peyronie disease;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6722","name":"Hook/hand, hvy dty, vol clos","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93652","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"78458","name":"Ven thrombosis images bilat","description":"Venous thrombosis imaging, venogram; bilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4351","name":"Straight tip urine catheter","description":"Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-10","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":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6403","name":"Sterile gauze>16 <= 48 sq in","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"31040","name":"Exploration behind upper jaw","description":"Pterygomaxillary fossa surgery, any approach","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"68362","name":"Revise eyelid lining","description":"Conjunctival flap; total (such as gunderson thin flap or purse string flap)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":625.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","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":"81015","name":"Microscopic exam of urine","description":"Urinalysis; microscopic only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"78018","name":"Thyroid met imaging body","description":"Thyroid carcinoma metastases imaging; whole body","date_of_service":"2026-05-10","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":"43622","name":"Removal of stomach","description":"Gastrectomy, total; with formation of intestinal pouch, any type","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"83065","name":"Hemoglobin thermolabile","description":"Hemoglobin; thermolabile","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6244","name":"Hydrogel drg >48 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"35870","name":"Repair vessel graft defect","description":"Repair of graft-enteric fistula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1099.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88263","name":"Chromosome analysis 45","description":"Chromosome analysis; count 45 cells for mosaicism, 2 karyotypes, with banding","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38550","name":"Removal neck/armpit lesion","description":"Excision of cystic hygroma, axillary or cervical; without deep neurovascular dissection","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":769.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":517.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84126","name":"Assay of feces porphyrins","description":"Porphyrins, feces, quantitative","date_of_service":"2026-05-10","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":"35286","name":"Rpr blvsl grf oth/th vn lxtr","description":"Repair blood vessel with graft other than vein; lower extremity","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92265","name":"Ndl oculoelectromyography 1+","description":"Needle oculoelectromyography, 1 or more extraocular muscles, 1 or both eyes, with interpretation and report","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90997","name":"Hemoperfusion","description":"Hemoperfusion (eg, with activated charcoal or resin)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85475","name":"Hemolysin acid","description":"Hemolysin, acid","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1684.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84285","name":"Assay of silica","description":"Silica","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31070","name":"Exploration of frontal sinus","description":"Sinusotomy frontal; external, simple (trephine operation)","date_of_service":"2026-05-10","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":"01844","name":"Anes vasc shunt/shunt revj","description":"Anesthesia for vascular shunt, or shunt revision, any type (eg, dialysis)","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77406","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85613","name":"Russell viper venom diluted","description":"Russell viper venom time (includes venom); diluted","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"63197","name":"Lam w/cordotomy 1stg thrc","description":"Laminectomy with cordotomy, with section of both spinothalamic tracts, 1 stage, thoracic","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0266","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21461","name":"Optx mndblr fx wo ntrdntl","description":"Open treatment of mandibular fracture; without interdental fixation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":997.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70552","name":"Mri brain stem w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","date_of_service":"2026-05-10","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":"40530","name":"Partial removal of lip","description":"Resection of lip, more than one-fourth, without reconstruction","date_of_service":"2026-05-10","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":"82310","name":"Assay of calcium","description":"Calcium; total","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78121","name":"Red cell mass multiple","description":"Red cell volume determination (separate procedure); multiple samplings","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28485","name":"Optx metatarsal fx each","description":"Open treatment of metatarsal fracture, includes internal fixation, when performed, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"31090","name":"Exploration of sinuses","description":"Sinusotomy, unilateral, 3 or more paranasal sinuses (frontal, maxillary, ethmoid, sphenoid)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":795.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44820","name":"Excision of mesentery lesion","description":"Excision of lesion of mesentery (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62361","name":"Implant spine infusion pump","description":"Implantation or replacement of device for intrathecal or epidural drug infusion; nonprogrammable pump","date_of_service":"2026-05-10","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":"86592","name":"Syphilis test non-trep qual","description":"Syphilis test, non-treponemal antibody; qualitative (eg, vdrl, rpr, art)","date_of_service":"2026-05-10","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":"15782","name":"Dermabrasion other than face","description":"Dermabrasion; regional, other than face","date_of_service":"2026-05-10","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":"86684","name":"Hemophilus influenza antibdy","description":"Antibody; haemophilus influenza","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"87285","name":"Treponema pallidum ag if","description":"Infectious agent antigen detection by immunofluorescent technique; treponema pallidum","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58672","name":"Laparoscopy fimbrioplasty","description":"Laparoscopy, surgical; with fimbrioplasty","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01420","name":"Anes cst appl rmv/rpr kne jt","description":"Anesthesia for all cast applications, removal, or repair involving knee joint","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":"J0365","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01920","name":"Anes cardiac catheterization","description":"Anesthesia for cardiac catheterization including coronary angiography and ventriculography (not to include swan-ganz catheter)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75822","name":"Vein x-ray arms/legs","description":"Venography, extremity, bilateral, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1223","name":"Wheelchair spec size w foot","description":"Wheelchair with detachable arms, footrests","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82544","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93603","name":"Right ventricular recording","description":"Right ventricular recording","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1217.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"53085","name":"Drainage of urinary leakage","description":"Drainage of perineal urinary extravasation; complicated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74000","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64740","name":"Incision of tongue nerve","description":"Transection or avulsion of; lingual nerve","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88185","name":"Flowcytometry/tc add-on","description":"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; each additional marker (list separately in addition to code for first marker)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1996.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80168","name":"Assay of ethosuximide","description":"Ethosuximide","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6232","name":"Hydrogel dsg>16<=48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size greater than 16 sq. in., but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21490","name":"Optx tmprmand dislocation","description":"Open treatment of temporomandibular dislocation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28725","name":"Arthrodesis subtalar","description":"Arthrodesis; subtalar","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69410","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"74710","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"84135","name":"Assay of pregnanediol","description":"Pregnanediol","date_of_service":"2026-05-10","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":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KF"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"28630","name":"Treat toe dislocation","description":"Closed treatment of metatarsophalangeal joint dislocation; without anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"48140","name":"Partial removal of pancreas","description":"Pancreatectomy, distal subtotal, with or without splenectomy; without pancreaticojejunostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1577.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":635.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1513.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51005","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"76965","name":"Echo guidance radiotherapy","description":"Ultrasonic guidance for interstitial radioelement application","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"L2090","name":"Hkafo unilat torsion ball br","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"72170","name":"X-ray exam of pelvis","description":"Radiologic examination, pelvis; 1 or 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"32664","name":"Thoracoscopy w/ th nrv exc","description":"Thoracoscopy, surgical; with thoracic sympathectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":675.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93612","name":"Intraventricular pacing","description":"Intraventricular pacing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84135","name":"Assay of pregnanediol","description":"Pregnanediol","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"50541","name":"Laparo ablate renal cyst","description":"Laparoscopy, surgical; ablation of renal cysts","date_of_service":"2026-05-10","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":"68420","name":"I&d lacrimal sac","description":"Incision, drainage of lacrimal sac (dacryocystotomy or dacryocystostomy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83986","name":"Assay ph body fluid nos","description":"Ph; body fluid, not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0632","name":"Lso sag rigid frame cust","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76400","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":671.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"46210","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0290","name":"Hosp bed fx ht w/o rails w/m","description":"Hospital bed, fixed height, without side rails, with mattress","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00190","name":"Anes px facial b1/skull nos","description":"Anesthesia for procedures on facial bones or skull; not otherwise specified","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","date_of_service":"2026-05-10","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":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":812.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51045","name":"Incise bladder/drain ureter","description":"Cystotomy, with insertion of ureteral catheter or stent (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"83540","name":"Assay of iron","description":"Iron","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"74176","name":"Ct abd & pelvis w/o contrast","description":"Computed tomography, abdomen and pelvis; without contrast material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21208","name":"Augmentation of facial bones","description":"Osteoplasty, facial bones; augmentation (autograft, allograft, or prosthetic implant)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1370.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75958","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1098.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83071","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"L6945","name":"Elbow disart myoelectronic c","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1110","name":"Wheelchair semi-recl detach","description":"Semi-reclining wheelchair, detachable arms (desk or full length) elevating leg rest","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1971","name":"Afo w/ankle joint, prefab","description":"Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-10","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":"82040","name":"Assay of serum albumin","description":"Albumin; serum, plasma or whole blood","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0239","name":"Hydrocollator unit portable","description":"Hydrocollator unit, portable","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43501","name":"Surgical repair of stomach","description":"Gastrotomy; with suture repair of bleeding ulcer","date_of_service":"2026-05-10","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":"ATP11","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0749","name":"Elec osteogen stim implanted","description":"Osteogenesis stimulator, electrical, surgically implanted","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"74355","name":"X-ray guide intestinal tube","description":"Percutaneous placement of enteroclysis tube, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-10","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":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73552","name":"X-ray exam of femur 2/>","description":"Radiologic examination, femur; minimum 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0245T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87275","name":"Influenza b ag if","description":"Infectious agent antigen detection by immunofluorescent technique; influenza b virus","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"32550","name":"Insert pleural cath","description":"Insertion of indwelling tunneled pleural catheter with cuff","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0492","name":"Tlso 3 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in th","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"77305","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"95904","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45540","name":"Correct rectal prolapse","description":"Proctopexy (eg, for prolapse); abdominal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43410","name":"Repair esophagus wound","description":"Suture of esophageal wound or injury; cervical approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":795.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43632","name":"Removal of stomach partial","description":"Gastrectomy, partial, distal; with gastrojejunostomy","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-10","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":"64508","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0762","name":"Trans elec jt stim dev sys","description":"Transcutaneous electrical joint stimulation device system, includes all accessories","date_of_service":"2026-05-10","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":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"89300","name":"Semen analysis w/huhner","description":"Semen analysis; presence and/or motility of sperm including huhner test (post coital)","date_of_service":"2026-05-10","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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"50780","name":"Reimplant ureter in bladder","description":"Ureteroneocystostomy; anastomosis of single ureter to bladder","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1203.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4268","name":"Female condom","description":"Contraceptive supply, condom, female, each","date_of_service":"2026-05-10","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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KL"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1461.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":776.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"24575","name":"Optx humeral epcndylr fx","description":"Open treatment of humeral epicondylar fracture, medial or lateral, includes internal fixation, when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":953.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"76391","name":"Mr elastography","description":"Magnetic resonance (eg, vibration) elastography","date_of_service":"2026-05-10","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":"69552","name":"Exc aurl glomus tum trnsmstd","description":"Excision aural glomus tumor; transmastoid","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"45800","name":"Repair rect/bladder fistula","description":"Closure of rectovesical fistula;","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"31086","name":"Removal of frontal sinus","description":"Sinusotomy frontal; nonobliterative, with osteoplastic flap, brow incision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88153","name":"Cytopath c/v redo","description":"Cytopathology, slides, cervical or vaginal; with manual screening and rescreening under physician supervision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93532","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1768.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78010","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73130","name":"X-ray exam of hand","description":"Radiologic examination, hand; minimum of 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35571","name":"Art byp pop-tibl-prl-other","description":"Bypass graft, with vein; popliteal-tibial, -peroneal artery or other distal vessels","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44391","name":"Colonoscopy for bleeding","description":"Colonoscopy through stoma; with control of bleeding, any method","date_of_service":"2026-05-10","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":"75994","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":890.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7060","name":"5% dextrose/water","description":"5% dextrose/water (500 ml = 1 unit)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1223.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01140","name":"Anes ntrplvabdmnl amputation","description":"Anesthesia for interpelviabdominal (hindquarter) amputation","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1700.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1025.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2440.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1414.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25927","name":"Amputation of hand","description":"Transmetacarpal amputation;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53060","name":"Drainage of urethra abscess","description":"Drainage of skenes gland abscess or cyst","date_of_service":"2026-05-10","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":"76940","name":"Us guide tissue ablation","description":"Ultrasound guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5973","name":"Ank-foot sys dors-plant flex","description":"Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0122","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"L4386","name":"Non-pneum walk boot pre cst","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"20900","name":"Removal of bone for graft","description":"Bone graft, any donor area; minor or small (eg, dowel or button)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7608","name":"Acetylcysteine non-comp unit","description":"Acetylcysteine, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per gram","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92145","name":"Corneal hysteresis deter","description":"Corneal hysteresis determination, by air impulse stimulation, unilateral or bilateral, with interpretation and report","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64742","name":"Incision of facial nerve","description":"Transection or avulsion of; facial nerve, differential or complete","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4706","name":"Bicarbonate conc sol per gal","description":"Bicarbonate concentrate, solution, for hemodialysis, per gallon","date_of_service":"2026-05-10","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":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95907","name":"Nvr cndj tst 1-2 studies","description":"Nerve conduction studies; 1-2 studies","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26037","name":"Decompress fingers/hand","description":"Decompressive fasciotomy, hand (excludes 26035)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":669.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"25535","name":"Cltx ulnar shft fx w/mnpj","description":"Closed treatment of ulnar shaft fracture; with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45135","name":"Excision of rectal prolapse","description":"Excision of rectal procidentia, with anastomosis; abdominal and perineal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1335.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1851","name":"Ko single upright prefab ots","description":"Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3900","name":"Hinge extension/flex wrist/f","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"48102","name":"Needle biopsy pancreas","description":"Biopsy of pancreas, percutaneous needle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"69960","name":"Release inner ear canal","description":"Decompression internal auditory canal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"56634","name":"Vlvctmy rad comp uni lymphad","description":"Vulvectomy, radical, complete; with unilateral inguinofemoral lymphadenectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1313.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51610","name":"Injection for bladder x-ray","description":"Injection procedure for retrograde urethrocystography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3766","name":"Ewhfo w/joint(s) cf","description":"Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"A6245","name":"Hydrogel drg <= 16 in w/bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"01200","name":"Anes all closed px hip joint","description":"Anesthesia for all closed procedures involving hip joint","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47505","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","date_of_service":"2026-05-10","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":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"78262","name":"Gastroesophageal reflux std","description":"Gastroesophageal reflux study","date_of_service":"2026-05-10","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":"92506","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5430","name":"Postop dsg ak ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, ak or knee disarticulation, each additional cast change and realignment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0941","name":"Gravity assisted traction de","description":"Gravity assisted traction device, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"23465","name":"Repair shoulder capsule","description":"Capsulorrhaphy, glenohumeral joint, posterior, with or without bone block","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1355.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5331","name":"Hip disart canadian sach ft","description":"Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","date_of_service":"2026-05-10","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":"83916","name":"Oligoclonal bands","description":"Oligoclonal immune (oligoclonal bands)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30118","name":"Removal of intranasal lesion","description":"Excision or destruction (eg, laser), intranasal lesion; external approach (lateral rhinotomy)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5501","name":"Diabetic custom molded shoe","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patients foot (custom molded shoe), per shoe","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"92552","name":"Pure tone audiometry air","description":"Pure tone audiometry (threshold); air only","date_of_service":"2026-05-10","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":"31254","name":"Nsl/sins ndsc w/prtl ethmdct","description":"Nasal/sinus endoscopy, surgical with ethmoidectomy; partial (anterior)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28035","name":"Decompression of tibia nerve","description":"Release, tarsal tunnel (posterior tibial nerve decompression)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":428.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77082","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"A6201","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"86146","name":"Beta-2 glycoprotein antibody","description":"Beta 2 glycoprotein i antibody, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41130","name":"Partial removal of tongue","description":"Glossectomy; hemiglossectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1289.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88261","name":"Chromosome analysis 5","description":"Chromosome analysis; count 5 cells, 1 karyotype, with banding","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41113","name":"Excision of tongue lesion","description":"Excision of lesion of tongue with closure; posterior one-third","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93880","name":"Extracranial bilat study","description":"Duplex scan of extracranial arteries; complete bilateral study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4313","name":"Catheter w/bag 3-way","description":"Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","date_of_service":"2026-05-10","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":"50370","name":"Rmvl transplanted rnl algrft","description":"Removal of transplanted renal allograft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4630","name":"Repl bat t.e.n.s. own by pt","description":"Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":659.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4036","name":"Cast sup lngleg cylndr ped f","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95866","name":"Needle emg hemidiaphragm","description":"Needle electromyography; hemidiaphragm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"89049","name":"Chct for mal hyperthermia","description":"Caffeine halothane contracture test (chct) for malignant hyperthermia susceptibility, including interpretation and report","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","date_of_service":"2026-05-10","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":"84110","name":"Assay of porphobilinogen","description":"Porphobilinogen, urine; quantitative","date_of_service":"2026-05-10","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":"27720","name":"Repair of tibia","description":"Repair of nonunion or malunion, tibia; without graft, (eg, compression technique)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1998.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-10","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":"86701","name":"Hiv-1antibody","description":"Antibody; hiv-1","date_of_service":"2026-05-10","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":"70370","name":"Throat x-ray & fluoroscopy","description":"Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86628","name":"Candida antibody","description":"Antibody; candida","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":896.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55815","name":"Extensive prostate surgery","description":"Prostatectomy, perineal radical; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1937.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L4397","name":"Static or dynami afo pre ots","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87495","name":"Cytomeg dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); cytomegalovirus, direct probe technique","date_of_service":"2026-05-10","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":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27365","name":"Resect femur/knee tumor","description":"Radical resection of tumor, femur or knee","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57296","name":"Revise vag graft open abd","description":"Revision (including removal) of prosthetic vaginal graft; open abdominal approach","date_of_service":"2026-05-10","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":"71015","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"83872","name":"Assay synovial fluid mucin","description":"Mucin, synovial fluid (ropes test)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6248","name":"Hydrogel drsg gel filler","description":"Hydrogel dressing, wound filler, gel, per fluid ounce","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"77066","name":"Dx mammo incl cad bi","description":"Diagnostic mammography, including computer-aided detection (cad) when performed; bilateral","date_of_service":"2026-05-10","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":"95868","name":"Ndl emg cranial nrv musc bi","description":"Needle electromyography; cranial nerve supplied muscles, bilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92610","name":"Evaluate swallowing function","description":"Evaluation of oral and pharyngeal swallowing function","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27146","name":"Incision of hip bone","description":"Osteotomy, iliac, acetabular or innominate bone;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1083.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5828","name":"Endo knee-shin fluid swg/sta","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2840","name":"Tibial length sock fx or equ","description":"Addition to lower extremity orthosis, tibial length sock, fracture or equal, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2018.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9202","name":"Goserelin acetate implant","description":"Goserelin acetate implant, per 3.6 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43324","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1429.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"33362","name":"Replace aortic valve open","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; open femoral artery approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1747.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"26418","name":"Repair finger tendon","description":"Repair, extensor tendon, finger, primary or secondary; without free graft, each tendon","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"25449","name":"Revj arthrp wrist joint","description":"Revision of arthroplasty, including removal of implant, wrist joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":868.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":"A4206","name":"1 cc sterile syringe&needle","description":"Syringe with needle, sterile, 1 cc or less, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1690","name":"Combination bilateral ho","description":"Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"36469","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1353.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"49565","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"19160","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"00216","name":"Anes icr px vascular px","description":"Anesthesia for intracranial procedures; vascular procedures","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.16,"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":"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":"2026-05-10","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":"L5400","name":"Postop dress & 1 cast chg bk","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee","date_of_service":"2026-05-10","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":"84460","name":"Alanine amino (alt) (sgpt)","description":"Transferase; alanine amino (alt) (sgpt)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"3080F","name":"Diast bp >= 90 mm hg","description":"Most recent diastolic blood pressure greater than or equal to 90 mm hg (htn, ckd, cad) (dm)","date_of_service":"2026-05-10","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":2.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"44310","name":"Ileostomy/jejunostomy","description":"Ileostomy or jejunostomy, non-tube","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1092.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"25400","name":"Repair radius or ulna","description":"Repair of nonunion or malunion, radius or ulna; without graft (eg, compression technique)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1287.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2206","name":"Lens sphcy bifocal 4.00d/ove","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-10","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":"99313","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["KL","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":"2026-05-10","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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1642","name":"Inj heparin sodium per 10 u","description":"Injection, heparin sodium, (heparin lock flush), per 10 units","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-10","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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2000","name":"Gastric suction pump hme mdl","description":"Gastric suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-10","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":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92995","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1205.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1634.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":629.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82107","name":"Alpha-fetoprotein l3","description":"Alpha-fetoprotein (afp); afp-l3 fraction isoform and total afp (including ratio)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4312","name":"Cath w/o bag 2-way silicone","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"G9686","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":"46505","name":"Chemodenervation anal musc","description":"Chemodenervation of internal anal sphincter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-10","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":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-10","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":"23920","name":"Disarticulation shoulder","description":"Disarticulation of shoulder;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1932","name":"Afo rig ant tib tcf/= custom","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":840.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95956","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"42400","name":"Biopsy of salivary gland","description":"Biopsy of salivary gland; needle","date_of_service":"2026-05-10","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":"41114","name":"Excision of tongue lesion","description":"Excision of lesion of tongue with closure; with local tongue flap","date_of_service":"2026-05-10","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":"34900","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1149.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9563","name":"P32 na phosphate","description":"Sodium phosphate p-32, therapeutic, per millicurie","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95908","name":"Nrv cndj tst 3-4 studies","description":"Nerve conduction studies; 3-4 studies","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42107","name":"Excision lesion mouth roof","description":"Excision, lesion of palate, uvula; with local flap closure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1142.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28080","name":"Removal of foot lesion","description":"Excision, interdigital (morton) neuroma, single, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1421.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00872","name":"Anes lithotrp esw water bath","description":"Anesthesia for lithotripsy, extracorporeal shock wave; with water bath","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28220","name":"Release of foot tendon","description":"Tenolysis, flexor, foot; single tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82143","name":"Amniotic fluid scan","description":"Amniotic fluid scan (spectrophotometric)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82950","name":"Glucose test","description":"Glucose; post glucose dose (includes glucose)","date_of_service":"2026-05-10","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":"41110","name":"Excision of tongue lesion","description":"Excision of lesion of tongue without closure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23540","name":"Cltx acromclav dislc wo mnpj","description":"Closed treatment of acromioclavicular dislocation; without manipulation","date_of_service":"2026-05-10","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":"92543","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25820","name":"Arthrd wrist lmtd w/o b1 grf","description":"Arthrodesis, wrist; limited, without bone graft (eg, intercarpal or radiocarpal)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":526.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15792","name":"Chem peel nonfacial epidrm","description":"Chemical peel, nonfacial; epidermal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"84480","name":"Assay triiodothyronine (t3)","description":"Triiodothyronine t3; total (tt-3)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"70130","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; complete, minimum of 3 views per side","date_of_service":"2026-05-10","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":"75658","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":728.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3180.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"37226","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2203","name":"Lens sphcyl bifocal 4.00d/.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55815","name":"Extensive prostate surgery","description":"Prostatectomy, perineal radical; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"33970","name":"Aortic circulation assist","description":"Insertion of intra-aortic balloon assist device through the femoral artery, open approach","date_of_service":"2026-05-10","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":"73090","name":"X-ray exam of forearm","description":"Radiologic examination; forearm, 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1212.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33201","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","date_of_service":"2026-05-10","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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0010","name":"Stnd wt frame power whlchr","description":"Standard - weight frame motorized/power wheelchair","date_of_service":"2026-05-10","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":"86804","name":"Hep c ab test confirm","description":"Hepatitis c antibody; confirmatory test (eg, immunoblot)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-05-10","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":"93882","name":"Extracranial uni/ltd study","description":"Duplex scan of extracranial arteries; unilateral or limited study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"J1945","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1095.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00454","name":"Anes px clav&scapula bx clav","description":"Anesthesia for procedures on clavicle and scapula; biopsy of clavicle","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0637","name":"Caspofungin acetate","description":"Injection, caspofungin acetate, 5 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75676","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":629.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1381.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0205","name":"Heat lamp with stand","description":"Heat lamp, with stand, includes bulb, or infrared element","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"J1960","name":"Levorphanol tartrate inj","description":"Injection, levorphanol tartrate, up to 2 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":756.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82330","name":"Assay of calcium","description":"Calcium; ionized","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"95956","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85660","name":"Rbc sickle cell test","description":"Sickling of rbc, reduction","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1011.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0945","name":"Belt/harness extremity","description":"Extremity belt/harness","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"00222","name":"Anes icr px ecoag icr nrv","description":"Anesthesia for intracranial procedures; electrocoagulation of intracranial nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"28272","name":"Release of toe joint each","description":"Capsulotomy; interphalangeal joint, each joint (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"G0106","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"82488","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":997.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"75885","name":"Vein x-ray liver w/hemodynam","description":"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":733.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-05-10","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":"G6006","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1967.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78807","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01130","name":"Anes body cast appl/revj","description":"Anesthesia for body cast application or revision","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75625","name":"Contrast exam abdominl aorta","description":"Aortography, abdominal, by serialography, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3967","name":"Sewho airplane w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KF"]}],"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":"2026-05-10","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":"93304","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1051.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87015","name":"Specimen infect agnt concntj","description":"Concentration (any type), for infectious agents","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27760","name":"Cltx medial ankle fx","description":"Closed treatment of medial malleolus fracture; without manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"28470","name":"Cltx metatarsal fx wo mnp ea","description":"Closed treatment of metatarsal fracture; without manipulation, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83663","name":"Fluoro polarize fetal lung","description":"Fetal lung maturity assessment; fluorescence polarization","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"51865","name":"Repair of bladder wound","description":"Cystorrhaphy, suture of bladder wound, injury or rupture; complicated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1008.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82205","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E0731","name":"Conductive garment for tens/","description":"Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patients skin by layers of fabric)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":"64738","name":"Incision of jaw nerve","description":"Transection or avulsion of; inferior alveolar nerve by osteotomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":523.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28755","name":"Fusion of big toe joint","description":"Arthrodesis, great toe; interphalangeal joint","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"76001","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"23210","name":"Radical rescj tumor scapula","description":"Radical resection of tumor; scapula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1065.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-10","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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4331","name":"Extension drainage tubing","description":"Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"21267","name":"Revise eye sockets","description":"Orbital repositioning, periorbital osteotomies, unilateral, with bone grafts; extracranial approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1820.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-05-10","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":"49419","name":"Insert tun ip cath w/port","description":"Insertion of tunneled intraperitoneal catheter, with subcutaneous port (ie, totally implantable)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93024","name":"Ergonovine provocation test","description":"Ergonovine provocation test","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70200","name":"X-ray exam of eye sockets","description":"Radiologic examination; orbits, complete, minimum of 4 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86612","name":"Blastomyces antibody","description":"Antibody; blastomyces","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"46210","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29805","name":"Sho arthrs dx +- synovial bx","description":"Arthroscopy, shoulder, diagnostic, with or without synovial biopsy (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"74249","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"78104","name":"Bone marrow imaging body","description":"Bone marrow imaging; whole body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"85613","name":"Russell viper venom diluted","description":"Russell viper venom time (includes venom); diluted","date_of_service":"2026-05-10","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":"28405","name":"Cltx calcaneal fx w/mnpj","description":"Closed treatment of calcaneal fracture; with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30630","name":"Repair nasal septum defect","description":"Repair nasal septal perforations","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":708.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0500","name":"Ippb all types","description":"Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source","date_of_service":"2026-05-10","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":"33710","name":"Repair of heart defects","description":"Repair sinus of valsalva fistula, with cardiopulmonary bypass; with repair of ventricular septal defect","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"49205","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E0984","name":"Add pwr tiller","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4234","name":"J-cell batt for glucose mon","description":"Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KL","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"90736","name":"Hzv vaccine live subq","description":"Zoster (shingles) vaccine (hzv), live, for subcutaneous injection","date_of_service":"2026-05-10","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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70328","name":"X-ray exam of jaw joint","description":"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral","date_of_service":"2026-05-10","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":"72198","name":"Mr angio pelvis w/o & w/dye","description":"Magnetic resonance angiography, pelvis, with or without contrast material(s)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1228.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"30117","name":"Removal of intranasal lesion","description":"Excision or destruction (eg, laser), intranasal lesion; internal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82485","name":"Assay chondroitin sulfate","description":"Chondroitin b sulfate, quantitative","date_of_service":"2026-05-10","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":"65900","name":"Remove eye lesion","description":"Removal of epithelial downgrowth, anterior chamber of eye","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":968.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28024","name":"Exploration of toe joint","description":"Arthrotomy, including exploration, drainage, or removal of loose or foreign body; interphalangeal joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":402.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-10","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":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":474.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"47715","name":"Excision of bile duct cyst","description":"Excision of choledochal cyst","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1115.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76080","name":"X-ray exam of fistula","description":"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-10","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":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L3925","name":"Fo pip dip jnt/sprng pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":676.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A4365","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"33222","name":"Relocation pocket pacemaker","description":"Relocation of skin pocket for pacemaker","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"G6001","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0972","name":"Lso corset front","description":"Lso, corset front","date_of_service":"2026-05-10","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":"82775","name":"Assay galactose transferase","description":"Galactose-1-phosphate uridyl transferase; quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62302","name":"Myelography lumbar injection","description":"Myelography via lumbar injection, including radiological supervision and interpretation; cervical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66761","name":"Revision of iris","description":"Iridotomy/iridectomy by laser surgery (eg, for glaucoma) (per session)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1524.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66762","name":"Revision of iris","description":"Iridoplasty by photocoagulation (1 or more sessions) (eg, for improvement of vision, for widening of anterior chamber angle)","date_of_service":"2026-05-10","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":"62201","name":"Brain cavity shunt w/scope","description":"Ventriculocisternostomy, third ventricle; stereotactic, neuroendoscopic method","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21151","name":"Rcnstj mdfc lefrtii w/b1 grf","description":"Reconstruction midface, lefort ii; any direction, requiring bone grafts (includes obtaining autografts)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1479.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78102","name":"Bone marrow imaging ltd","description":"Bone marrow imaging; limited area","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"69209","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen using irrigation/lavage, unilateral","date_of_service":"2026-05-10","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":"92287","name":"Ant sgm img ir flrscn angrph","description":"Anterior segment imaging with interpretation and report; with fluorescein angiography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"34051","name":"Removal of artery clot","description":"Embolectomy or thrombectomy, with or without catheter; innominate, subclavian artery, by thoracic incision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42955","name":"Surgical opening of throat","description":"Pharyngostomy (fistulization of pharynx, external for feeding)","date_of_service":"2026-05-10","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":"E2343","name":"W/c dpth 22-25 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches","date_of_service":"2026-05-10","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":"01520","name":"Anes px veins lower leg nos","description":"Anesthesia for procedures on veins of lower leg; not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"27705","name":"Osteotomy tibia","description":"Osteotomy; tibia","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-05-10","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":"46761","name":"Repair of anal sphincter","description":"Sphincteroplasty, anal, for incontinence, adult; levator muscle imbrication (park posterior anal repair)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83905","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"25301","name":"Fusion of tendons at wrist","description":"Tenodesis at wrist; extensors of fingers","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1026.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"72069","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0948","name":"Fracture frame attachmnts ce","description":"Fracture frame, attachments for complex cervical traction","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-05-10","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":"70390","name":"X-ray exam of salivary duct","description":"Sialography, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0002A","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"48520","name":"Fuse pancreas cyst and bowel","description":"Internal anastomosis of pancreatic cyst to gastrointestinal tract; direct","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1083.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"59514","name":"Cesarean delivery only","description":"Cesarean delivery only;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":815.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21462","name":"Optx mndblr fx w/ntrdntl","description":"Open treatment of mandibular fracture; with interdental fixation","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","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":"95909","name":"Nrv cndj tst 5-6 studies","description":"Nerve conduction studies; 5-6 studies","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0504","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"88318","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78725","name":"Kidney function study","description":"Kidney function study, non-imaging radioisotopic study","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3531.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0621","name":"Sio flex pelvic/sacr pre ots","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":943.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54800","name":"Biopsy of epididymis","description":"Biopsy of epididymis, needle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71101","name":"X-ray exam unilat ribs/chest","description":"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views","date_of_service":"2026-05-10","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":"25119","name":"Partial removal of ulna","description":"Synovectomy, extensor tendon sheath, wrist, single compartment; with resection of distal ulna","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6711","name":"Ped term dev, hook, vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83825","name":"Assay of mercury","description":"Mercury, quantitative","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21138","name":"Rdctj forehead cntrg&prostc","description":"Reduction forehead; contouring and application of prosthetic material or bone graft (includes obtaining autograft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1062.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":638.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"83695","name":"Assay of lipoprotein(a)","description":"Lipoprotein (a)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"73110","name":"X-ray exam of wrist","description":"Radiologic examination, wrist; complete, minimum of 3 views","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"61570","name":"Remove foreign body brain","description":"Craniectomy or craniotomy; with excision of foreign body from brain","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2013.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"35460","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"63746","name":"Removal of spinal shunt","description":"Removal of entire lumbosubarachnoid shunt system without replacement","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1167.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73520","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KL"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82043","name":"Ur albumin quantitative","description":"Albumin; urine (eg, microalbumin), quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0737","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68530","name":"Clearance of tear duct","description":"Removal of foreign body or dacryolith, lacrimal passages","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45386","name":"Colonoscopy w/balloon dilat","description":"Colonoscopy, flexible; with transendoscopic balloon dilation","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1826.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67710","name":"Severing tarsorrhaphy","description":"Severing of tarsorrhaphy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"82164","name":"Angiotensin i enzyme test","description":"Angiotensin i - converting enzyme (ace)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":"00530","name":"Anes perm transvns pm insj","description":"Anesthesia for permanent transvenous pacemaker insertion","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75827","name":"Vein x-ray chest","description":"Venography, caval, superior, with serialography, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"95904","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"19325","name":"Breast augmentation w/implt","description":"Breast augmentation with implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"72050","name":"X-ray exam neck spine 4/5vws","description":"Radiologic examination, spine, cervical; 4 or 5 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KN"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":880.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2290.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78231","name":"Salivary glnd img serial img","description":"Salivary gland imaging; with serial images","date_of_service":"2026-05-10","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":"20662","name":"Application halo pelvic","description":"Application of halo, including removal; pelvic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"77327","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"94240","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75736","name":"Artery x-rays pelvis","description":"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25118","name":"Excise wrist tendon sheath","description":"Synovectomy, extensor tendon sheath, wrist, single compartment;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25065","name":"Biopsy forearm soft tissues","description":"Biopsy, soft tissue of forearm and/or wrist; superficial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"75560","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4927","name":"Non-sterile gloves","description":"Gloves, non-sterile, per 100","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"57335","name":"Repair vagina","description":"Vaginoplasty for intersex state","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33361","name":"Replace aortic valve perq","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; percutaneous femoral artery approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1632.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"31572","name":"Largsc w/laser dstrj les","description":"Laryngoscopy, flexible; with ablation or destruction of lesion(s) with laser, unilateral","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70100","name":"X-ray exam of jaw <4views","description":"Radiologic examination, mandible; partial, less than 4 views","date_of_service":"2026-05-10","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":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64410","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"24310","name":"Tnot opn elbw to sho ea tdn","description":"Tenotomy, open, elbow to shoulder, each tendon","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":587.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"27078","name":"Rsect hip tum incl femur","description":"Radical resection of tumor; ischial tuberosity and greater trochanter of femur","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J0289","name":"Amphotericin b liposome inj","description":"Injection, amphotericin b liposome, 10 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["GT","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36810","name":"Insertion of cannula","description":"Insertion of cannula for hemodialysis, other purpose (separate procedure); arteriovenous, external (scribner type)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35606","name":"Bpg carotid-subclavian","description":"Bypass graft, with other than vein; carotid-subclavian","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1031.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68330","name":"Revise eyelid lining","description":"Repair of symblepharon; conjunctivoplasty, without graft","date_of_service":"2026-05-10","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":"78428","name":"Cardiac shunt imaging","description":"Cardiac shunt detection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-10","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":"78806","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0220","name":"Thor rib belt custom fabrica","description":"Thoracic, rib belt, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"87552","name":"Mycobacteria dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria species, quantification","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68440","name":"Snip inc lacrimal punctum","description":"Snip incision of lacrimal punctum","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":653.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0560","name":"Humidifier supplemental w/ i","description":"Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1610","name":"Ho frejka cov only pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26320","name":"Removal of implant from hand","description":"Removal of implant from finger or hand","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24360","name":"Reconstruct elbow joint","description":"Arthroplasty, elbow; with membrane (eg, fascial)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1686","name":"Ho post-op hip abduction","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72132","name":"Ct lumbar spine w/dye","description":"Computed tomography, lumbar spine; with contrast material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4321","name":"Cath therapeutic irrig agent","description":"Therapeutic agent for urinary catheter irrigation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":337.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86485","name":"Skin test candida","description":"Skin test; candida","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78807","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"97022","name":"Whirlpool therapy","description":"Application of a modality to 1 or more areas; whirlpool","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1588.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2006","name":"Kaf sng/dbl swg/stn mcpr cus","description":"Knee ankle foot device, any material, single or double upright, swing and stance phase microprocessor control with adjustability, includes all components (e.g., sensors, batteries, charger), any type activation, with or without ankle joint(s), custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"28810","name":"Amputation toe & metatarsal","description":"Amputation, metatarsal, with toe, single","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2319.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97520","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"0504T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3762","name":"Eo rigid w/o joints pre ots","description":"Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"44210","name":"Laparo total proctocolectomy","description":"Laparoscopy, surgical; colectomy, total, abdominal, without proctectomy, with ileostomy or ileoproctostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1922.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66770","name":"Removal of inner eye lesion","description":"Destruction of cyst or lesion iris or ciliary body (nonexcisional procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"35881","name":"Revise graft w/vein","description":"Revision, lower extremity arterial bypass, without thrombectomy, open; with segmental vein interposition","date_of_service":"2026-05-10","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":"58553","name":"Laparo-vag hyst complex","description":"Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g;","date_of_service":"2026-05-10","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":"39400","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2193.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","date_of_service":"2026-05-10","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":"90862","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A6412","name":"Occlusive eye patch","description":"Eye patch, occlusive, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5703","name":"Symes ankle w/o (sach) foot","description":"Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1154.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6925","name":"Wrist disart myoelectronic c","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":708.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"42300","name":"Drainage of salivary gland","description":"Drainage of abscess; parotid, simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21490","name":"Optx tmprmand dislocation","description":"Open treatment of temporomandibular dislocation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58822","name":"Drain ovary abscess percut","description":"Drainage of ovarian abscess; abdominal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25415","name":"Repair radius & ulna","description":"Repair of nonunion or malunion, radius and ulna; without graft (eg, compression technique)","date_of_service":"2026-05-10","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":"23550","name":"Optx acromclv dislc aqt/chrn","description":"Open treatment of acromioclavicular dislocation, acute or chronic;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2962.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85044","name":"Manual reticulocyte count","description":"Blood count; reticulocyte, manual","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6553","name":"G com stcking bk 30-40 custm","description":"Gradient compression stocking, below knee, 30-40 mmhg, custom, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27530","name":"Treat knee fracture","description":"Closed treatment of tibial fracture, proximal (plateau); without manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8683","name":"Radiofq trsmtr for implt neu","description":"Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"31585","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":532.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"Q4016","name":"Cast sup gauntlet ped fbrgls","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), fiberglass","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6019","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73090","name":"X-ray exam of forearm","description":"Radiologic examination; forearm, 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J0256","name":"Alpha 1 proteinase inhibitor","description":"Injection, alpha 1 proteinase inhibitor (human), not otherwise specified, 10 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5611","name":"Ak 4 bar link w/fric swing","description":"Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4029","name":"Cast sup long leg plaster","description":"Cast supplies, long leg cast, adult (11 years +), plaster","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":683.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38200","name":"Injection for spleen x-ray","description":"Injection procedure for splenoportography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3702","name":"Eo w/o joints cf","description":"Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-10","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":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-05-10","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":"A4429","name":"Urine ost pouch w bltinconv","description":"Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92250","name":"Fundus photography w/i&r","description":"Fundus photography with interpretation and report","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":871.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1271.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"23473","name":"Revis reconst shoulder joint","description":"Revision of total shoulder arthroplasty, including allograft when performed; humeral or glenoid component","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33755","name":"Shunt as-aort to pulm art","description":"Shunt; ascending aorta to pulmonary artery (waterston type operation)","date_of_service":"2026-05-10","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":"84105","name":"Assay of urine phosphorus","description":"Phosphorus inorganic (phosphate); urine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77315","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"74410","name":"Urography nfs drip&/bolus","description":"Urography, infusion, drip technique and/or bolus technique;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45331","name":"Sigmoidoscopy and biopsy","description":"Sigmoidoscopy, flexible; with biopsy, single or multiple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":321.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6154","name":"Wound pouch each","description":"Wound pouch, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50722","name":"Release of ureter","description":"Ureterolysis for ovarian vein syndrome","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0740","name":"Non-implant pelv flr e-stim","description":"Non-implanted pelvic floor electrical stimulator, complete system","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"32035","name":"Thoracostomy w/rib resection","description":"Thoracostomy; with rib resection for empyema","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31656","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4049","name":"Finger splint, static","description":"Finger splint, static","date_of_service":"2026-05-10","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":"86185","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":531.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6455","name":"Self-adher band >=5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard","date_of_service":"2026-05-10","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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-10","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":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27769","name":"Optx post ankle fx","description":"Open treatment of posterior malleolus fracture, includes internal fixation, when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90837","name":"Psytx w pt 60 minutes","description":"Psychotherapy, 60 minutes with patient","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83914","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"35261","name":"Rpr blvsl grf oth/thn vn nck","description":"Repair blood vessel with graft other than vein; neck","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67902","name":"Repair eyelid defect","description":"Repair of blepharoptosis; frontalis muscle technique with autologous fascial sling (includes obtaining fascia)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":574.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-10","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":"85250","name":"Clot factor ix ptc/chrstmas","description":"Clotting; factor ix (ptc or christmas)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"J2792","name":"Rho(d) immune globulin h, sd","description":"Injection, rho d immune globulin, intravenous, human, solvent detergent, 100 iu","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0455","name":"Tlso flex trnk sj-t9 pre ots","description":"Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, pref","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1031.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-10","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":"88323","name":"Consltj&reprt matrl prep sld","description":"Consultation and report on referred material requiring preparation of slides","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"27416","name":"Osteochondral knee autograft","description":"Osteochondral autograft(s), knee, open (eg, mosaicplasty) (includes harvesting of autograft[s])","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5580","name":"Prep ak ischial thermo mold","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45382","name":"Colonoscopy w/control bleed","description":"Colonoscopy, flexible; with control of bleeding, any method","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64782","name":"Remove limb nerve lesion","description":"Excision of neuroma; hand or foot, except digital nerve","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2035","name":"Kafo plastic pediatric size","description":"Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":642.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1910","name":"Afo sing bar clasp attach sh","description":"Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"72265","name":"Myelography l-s spine","description":"Myelography, lumbosacral, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0710","name":"Ctlso a-p-l control w/ inter","description":"Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type)","date_of_service":"2026-05-10","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":"82365","name":"Calculus spectroscopy","description":"Calculus; infrared spectroscopy","date_of_service":"2026-05-10","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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00124","name":"Anes px ear otoscopy","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; otoscopy","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86185","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82355","name":"Calculus analysis qual","description":"Calculus; qualitative analysis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"0101T","name":"Esw muscskel sys nos","description":"Extracorporeal shock wave involving musculoskeletal system, not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20550","name":"Njx 1 tendon sheath/ligament","description":"Injection(s); single tendon sheath, or ligament, aponeurosis (eg, plantar fascia)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31750","name":"Tracheoplasty cervical","description":"Tracheoplasty; cervical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95824","name":"Eeg cerebral death only","description":"Electroencephalogram (eeg); cerebral death evaluation only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"66184","name":"Revision of aqueous shunt","description":"Revision of aqueous shunt to extraocular equatorial plate reservoir; without graft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87177","name":"Ova and parasites smears","description":"Ova and parasites, direct smears, concentration and identification","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0265","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"43326","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"47741","name":"Fuse gallbladder & bowel","description":"Cholecystoenterostomy; roux-en-y with gastroenterostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1490.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"86001","name":"Allergen specific igg","description":"Allergen specific igg quantitative or semiquantitative, each allergen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27253","name":"Treat hip dislocation","description":"Open treatment of hip dislocation, traumatic, without internal fixation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1136.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31020","name":"Exploration maxillary sinus","description":"Sinusotomy, maxillary (antrotomy); intranasal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1306.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82980","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"95911","name":"Nrv cndj test 9-10 studies","description":"Nerve conduction studies; 9-10 studies","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0466","name":"Home vent non-invasive inter","description":"Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1949.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","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":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78468","name":"Heart infarct image (ef)","description":"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77776","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":374.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-10","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":"31365","name":"Removal of larynx","description":"Laryngectomy; total, with radical neck dissection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1925.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-05-10","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":"43206","name":"Esoph optical endomicroscopy","description":"Esophagoscopy, flexible, transoral; with optical endomicroscopy","date_of_service":"2026-05-10","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":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"85379","name":"Fibrin degradation quant","description":"Fibrin degradation products, d-dimer; quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"53085","name":"Drainage of urinary leakage","description":"Drainage of perineal urinary extravasation; complicated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"69718","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"75885","name":"Vein x-ray liver w/hemodynam","description":"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83071","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77761","name":"Apply intrcav radiat simple","description":"Intracavitary radiation source application; simple","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR","KF",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6203","name":"Composite drsg <= 16 sq in","description":"Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86696","name":"Herpes simplex type 2 test","description":"Antibody; herpes simplex, type 2","date_of_service":"2026-05-10","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":"84127","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"41805","name":"Removal foreign body gum","description":"Removal of embedded foreign body from dentoalveolar structures; soft tissues","date_of_service":"2026-05-10","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":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76975","name":"Gi endoscopic ultrasound","description":"Gastrointestinal endoscopic ultrasound, supervision and interpretation","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01922","name":"Anes n-invas img/radj ther","description":"Anesthesia for non-invasive imaging or radiation therapy","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2844.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33813","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72100","name":"X-ray exam l-s spine 2/3 vws","description":"Radiologic examination, spine, lumbosacral; 2 or 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41822","name":"Excision of gum lesion","description":"Excision of fibrous tuberosities, dentoalveolar structures","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2220","name":"Lens bifocal add over 3.25d","description":"Bifocal add over 3.25d","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J9093","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"48554","name":"Transpl allograft pancreas","description":"Transplantation of pancreatic allograft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2525.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"92609","name":"Use of speech device service","description":"Therapeutic services for the use of speech-generating device, including programming and modification","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86063","name":"Antistreptolysin o screen","description":"Antistreptolysin 0; screen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"96040","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6900","name":"Hand restorat thumb/1 finger","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining","date_of_service":"2026-05-10","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":"67808","name":"Remove eyelid lesion(s)","description":"Excision of chalazion; under general anesthesia and/or requiring hospitalization, single or multiple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64859","name":"Nerve surgery","description":"Suture of each additional major peripheral nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":321.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"30540","name":"Rpr choanal atresia ntranasl","description":"Repair choanal atresia; intranasal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93623","name":"Prgrmd stimj&pacg iv rx nfs","description":"Programmed stimulation and pacing after intravenous drug infusion (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3965","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.16,"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":"A9562","name":"Tc99m mertiatide","description":"Technetium tc-99m mertiatide, diagnostic, per study dose, up to 15 millicuries","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"58346","name":"Insert heyman uteri capsule","description":"Insertion of heyman capsules for clinical brachytherapy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":498.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":764.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4216","name":"Parenteral nutrition additiv","description":"Parenteral nutrition; additives (vitamins, trace elements, heparin, electrolytes), home mix, per day","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L6707","name":"Term dev mech hook vol close","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35632","name":"Bpg ilio-celiac","description":"Bypass graft, with other than vein; ilio-celiac","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70544","name":"Mr angiography head w/o dye","description":"Magnetic resonance angiography, head; without contrast material(s)","date_of_service":"2026-05-10","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":"33507","name":"Repair art intramural","description":"Repair of anomalous (eg, intramural) aortic origin of coronary artery by unroofing or translocation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2133.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"77082","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82154","name":"Androstanediol glucuronide","description":"Androstanediol glucuronide","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1942.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"95869","name":"Ndl emg thrc paraspinal musc","description":"Needle electromyography; thoracic paraspinal muscles (excluding t1 or t12)","date_of_service":"2026-05-10","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":"45500","name":"Repair of rectum","description":"Proctoplasty; for stenosis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"32655","name":"Thoracoscopy resect bullae","description":"Thoracoscopy, surgical; with resection-plication of bullae, includes any pleural procedure when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20912","name":"Remove cartilage for graft","description":"Cartilage graft; nasal septum","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86688","name":"Htlv-ii antibody","description":"Antibody; htlv-ii","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15832","name":"Exc excessive skin thigh","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); thigh","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2019.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26070","name":"Explore/treat hand joint","description":"Arthrotomy, with exploration, drainage, or removal of loose or foreign body; carpometacarpal joint","date_of_service":"2026-05-10","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":"71046","name":"X-ray exam chest 2 views","description":"Radiologic examination, chest; 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01844","name":"Anes vasc shunt/shunt revj","description":"Anesthesia for vascular shunt, or shunt revision, any type (eg, dialysis)","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"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":"2026-05-10","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":"80101","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"58820","name":"Drain ovary abscess open","description":"Drainage of ovarian abscess; vaginal approach, open","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1437.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67715","name":"Canthotomy","description":"Canthotomy (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"83945","name":"Assay of oxalate","description":"Oxalate","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"93990","name":"Doppler flow testing","description":"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75945","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":759.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"29715","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"44404","name":"Colonoscopy w/injection","description":"Colonoscopy through stoma; with directed submucosal injection(s), any substance","date_of_service":"2026-05-10","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":"95956","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26035","name":"Decompress fingers/hand","description":"Decompression fingers and/or hand, injection injury (eg, grease gun)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":740.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74021","name":"Radex abdomen 3+ views","description":"Radiologic examination, abdomen; 3 or more views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5055","name":"Stoma cap","description":"Stoma cap","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87472","name":"Bartonella dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); bartonella henselae and bartonella quintana, quantification","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":"24350","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4542","name":"Small disposable underpad","description":"Incontinence product, disposable underpad, small size, each","date_of_service":"2026-05-10","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":"27454","name":"Realignment of thigh bone","description":"Osteotomy, multiple, with realignment on intramedullary rod, femoral shaft (eg, sofield type procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1510.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2570.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","date_of_service":"2026-05-10","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":"24102","name":"Arthrt elbow w/synovectomy","description":"Arthrotomy, elbow; with synovectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"92135","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1238","name":"Fld ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, folding, adjustable, without seating system","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35540","name":"Art byp grft aortbifemoral","description":"Bypass graft, with vein; aortobifemoral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2165.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":625.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"21199","name":"Reconstr lwr jaw w/advance","description":"Osteotomy, mandible, segmental; with genioglossus advancement","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1175.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"94150","name":"Vital capacity test","description":"Vital capacity, total (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30310","name":"Remove nasal foreign body","description":"Removal foreign body, intranasal; requiring general anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":543.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"K0010","name":"Stnd wt frame power whlchr","description":"Standard - weight frame motorized/power wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30630","name":"Repair nasal septum defect","description":"Repair nasal septal perforations","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"29405","name":"Appl short leg cast","description":"Application of short leg cast (below knee to toes);","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","date_of_service":"2026-05-10","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":"76778","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4296","name":"Coude tip hydrophilic cath","description":"Intermittent urinary catheter; coude (curved) tip, hydrophilic coating, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"27428","name":"Reconstruction knee","description":"Ligamentous reconstruction (augmentation), knee; intra-articular (open)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21210","name":"Face bone graft","description":"Graft, bone; nasal, maxillary or malar areas (includes obtaining graft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1591.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"L0633","name":"Lso sc r pos/lat pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"70210","name":"X-ray exam of sinuses","description":"Radiologic examination, sinuses, paranasal, less than 3 views","date_of_service":"2026-05-10","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":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":977.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0783","name":"Programmable infusion pump","description":"Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4728.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"28193","name":"Removal of foot foreign body","description":"Removal of foreign body, foot; complicated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1048.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":980.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6694","name":"Elbow socket ins use w/lock","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0205","name":"Heat lamp with stand","description":"Heat lamp, with stand, includes bulb, or infrared element","date_of_service":"2026-05-10","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":"82950","name":"Glucose test","description":"Glucose; post glucose dose (includes glucose)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0620","name":"Cap bld skin piercing laser","description":"Skin piercing device for collection of capillary blood, laser, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"61571","name":"Incise skull for brain wound","description":"Craniectomy or craniotomy; with treatment of penetrating wound of brain","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2239.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96409","name":"Chemo iv push sngl drug","description":"Chemotherapy administration; intravenous, push technique, single or initial substance/drug","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44383","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92547","name":"Supplemental electrical test","description":"Use of vertical electrodes (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"94150","name":"Vital capacity test","description":"Vital capacity, total (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46250","name":"Remove ext hem groups 2+","description":"Hemorrhoidectomy, external, 2 or more columns/groups","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8701","name":"Ewh s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand with single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.68,"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":"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":"2026-05-10","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":"99296","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":464.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-10","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":"47510","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"89300","name":"Semen analysis w/huhner","description":"Semen analysis; presence and/or motility of sperm including huhner test (post coital)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"85732","name":"Thromboplastin time partial","description":"Thromboplastin time, partial (ptt); substitution, plasma fractions, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"20551","name":"Njx 1 tendon origin/insj","description":"Injection(s); single tendon origin/insertion","date_of_service":"2026-05-10","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":"31080","name":"Removal of frontal sinus","description":"Sinusotomy frontal; obliterative without osteoplastic flap, brow incision (includes ablation)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1184.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L5961","name":"Endo poly hip, pneu/hyd/rot","description":"Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"58350","name":"Reopen fallopian tube","description":"Chromotubation of oviduct, including materials","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61557","name":"Incise skull/sutures","description":"Craniotomy for craniosynostosis; bifrontal bone flap","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1534.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84157","name":"Assay of protein other","description":"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid)","date_of_service":"2026-05-10","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":"86510","name":"Histoplasmosis skin test","description":"Skin test; histoplasmosis","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-10","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":"63265","name":"Excise intraspinl lesion crv","description":"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; cervical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1834.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":638.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8631","name":"Mcp joint repl 2 pc or more","description":"Metacarpal phalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes entire system)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27147","name":"Revision of hip bone","description":"Osteotomy, iliac, acetabular or innominate bone; with open reduction of hip","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1243.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1321.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86692","name":"Hepatitis delta agent antbdy","description":"Antibody; hepatitis, delta agent","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27370","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2356.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63252","name":"Revise spine cord vsl thrlmb","description":"Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracolumbar","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2801.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6216","name":"Non-sterile gauze<=16 sq in","description":"Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"99289","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01360","name":"Anes open px lower 1/3 femur","description":"Anesthesia for all open procedures on lower one-third of femur","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":840.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26020","name":"Drain hand tendon sheath","description":"Drainage of tendon sheath, digit and/or palm, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":462.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"35721","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88104","name":"Cytopath fl nongyn smears","description":"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"90804","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1022.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","KL","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26605","name":"Treat metacarpal fracture","description":"Closed treatment of metacarpal fracture, single; with manipulation, each bone","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"20200","name":"Muscle biopsy superficial","description":"Biopsy, muscle; superficial","date_of_service":"2026-05-10","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":"37618","name":"Ligation major artery xtr","description":"Ligation, major artery (eg, post-traumatic, rupture); extremity","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46716","name":"Rep perf anoper/vestib fistu","description":"Repair of low imperforate anus; with transposition of anoperineal or anovestibular fistula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1011.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83070","name":"Assay of hemosiderin qual","description":"Hemosiderin, qualitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"59300","name":"Episiotomy or vaginal repair","description":"Episiotomy or vaginal repair, by other than attending","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27740","name":"Repair of leg epiphyses","description":"Arrest, epiphyseal (epiphysiodesis), any method, combined, proximal and distal tibia and fibula;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L0972","name":"Lso corset front","description":"Lso, corset front","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A6196","name":"Alginate dressing <=16 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing","date_of_service":"2026-05-10","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":"21347","name":"Opn tx nasomax fx multple","description":"Open treatment of nasomaxillary complex fracture (lefort ii type); requiring multiple open approaches","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74710","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KF"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"54163","name":"Repair of circumcision","description":"Repair incomplete circumcision","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"63196","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1923.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31525","name":"Dx laryngoscopy excl nb","description":"Laryngoscopy direct, with or without tracheoscopy; diagnostic, except newborn","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92520","name":"Laryngeal function studies","description":"Laryngeal function studies (ie, aerodynamic testing and acoustic testing)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92984","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"40527","name":"Reconstruct lip with flap","description":"Excision of lip; full thickness, reconstruction with cross lip flap (abbe-estlander)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J0587","name":"Inj, rimabotulinumtoxinb","description":"Injection, rimabotulinumtoxinb, 100 units","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":632.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"88325","name":"Consltj compre rvw rec reprt","description":"Consultation, comprehensive, with review of records and specimens, with report on referred material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3652","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93024","name":"Ergonovine provocation test","description":"Ergonovine provocation test","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2114","name":"Afo tib fx semi-rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":"33406","name":"Replacement aortic valve opn","description":"Replacement, aortic valve, open, with cardiopulmonary bypass; with allograft valve (freehand)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"85378","name":"Fibrin degrade semiquant","description":"Fibrin degradation products, d-dimer; qualitative or semiquantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00454","name":"Anes px clav&scapula bx clav","description":"Anesthesia for procedures on clavicle and scapula; biopsy of clavicle","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75880","name":"Vein x-ray eye socket","description":"Venography, orbital, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0466","name":"Tlso r fram soft ant pre cst","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled,","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"25415","name":"Repair radius & ulna","description":"Repair of nonunion or malunion, radius and ulna; without graft (eg, compression technique)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"88107","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33611","name":"Repair double ventricle","description":"Repair of double outlet right ventricle with intraventricular tunnel repair;","date_of_service":"2026-05-10","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":"49540","name":"Repair lumbar hernia","description":"Repair lumbar hernia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78812","name":"Pet image skull-thigh","description":"Positron emission tomography (pet) imaging; skull base to mid-thigh","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"36511","name":"Apheresis wbc","description":"Therapeutic apheresis; for white blood cells","date_of_service":"2026-05-10","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":"49520","name":"Rerepair ing hernia reduce","description":"Repair recurrent inguinal hernia, any age; reducible","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-05-10","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":"19220","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1162.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q4076","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4265","name":"Paraffin","description":"Paraffin, per pound","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-10","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":"35189","name":"Rpr acq av fistula thrx&abd","description":"Repair, acquired or traumatic arteriovenous fistula; thorax and abdomen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1961.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1397.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73090","name":"X-ray exam of forearm","description":"Radiologic examination; forearm, 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45500","name":"Repair of rectum","description":"Proctoplasty; for stenosis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KM"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94729","name":"Diffusing capacity","description":"Diffusing capacity (eg, carbon monoxide, membrane) (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.64,"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":"65222","name":"Remove foreign body from eye","description":"Removal of foreign body, external eye; corneal, with slit lamp","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90817","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"35612","name":"Bpg subclavian-subclavian","description":"Bypass graft, with other than vein; subclavian-subclavian","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"67412","name":"Explore/treat eye socket","description":"Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of lesion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":941.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"15780","name":"Dermabrasion total face","description":"Dermabrasion; total face (eg, for acne scarring, fine wrinkling, rhytids, general keratosis)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":733.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KC"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":871.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0279","name":"Tomosynthesis, mammo","description":"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"52353","name":"Cystouretero w/lithotripsy","description":"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76821","name":"Middle cerebral artery echo","description":"Doppler velocimetry, fetal; middle cerebral artery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J1835","name":"Itraconazole injection","description":"Injection, itraconazole, 50 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":"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":"2026-05-10","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":"27105","name":"Transfer of spinal muscle","description":"Transfer paraspinal muscle to hip (includes fascial or tendon extension graft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"82951","name":"Glucose tolerance test (gtt)","description":"Glucose; tolerance test (gtt), 3 specimens (includes glucose)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1719.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32607","name":"Thoracoscopy w/bx infiltrate","description":"Thoracoscopy; with diagnostic biopsy(ies) of lung infiltrate(s) (eg, wedge, incisional), unilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"28540","name":"Treat foot dislocation","description":"Closed treatment of tarsal bone dislocation, other than talotarsal; without anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68040","name":"Treatment of eyelid lesions","description":"Expression of conjunctival follicles (eg, for trachoma)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91012","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"70373","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99488","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"78700","name":"Kidney imaging morphol","description":"Kidney imaging morphology;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2010","name":"Kafo sng solid stirrup w/o j","description":"Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), without knee joint, custom fabricated","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27132","name":"Total hip arthroplasty","description":"Conversion of previous hip surgery to total hip arthroplasty, with or without autograft or allograft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E1037","name":"Transport chair, ped size","description":"Transport chair, pediatric size","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31513","name":"Injection into vocal cord","description":"Laryngoscopy, indirect; with vocal cord injection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5614","name":"4-bar link above knee w/swng","description":"Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":822.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"46285","name":"Remove anal fist 2 stage","description":"Surgical treatment of anal fistula (fistulectomy/fistulotomy); second stage","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"42600","name":"Closure of salivary fistula","description":"Closure salivary fistula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":419.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"27470","name":"Repair of thigh","description":"Repair, nonunion or malunion, femur, distal to head and neck; without graft (eg, compression technique)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1395.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"43045","name":"Esophagotomy thrc rmvl fb","description":"Esophagotomy, thoracic approach, with removal of foreign body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"75957","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74355","name":"X-ray guide intestinal tube","description":"Percutaneous placement of enteroclysis tube, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65781","name":"Ocular reconst transplant","description":"Ocular surface reconstruction; limbal stem cell allograft (eg, cadaveric or living donor)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-10","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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00922","name":"Anes px male gent sem ves","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); seminal vesicles","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85598","name":"Hexagnal phosph pltlt neutrl","description":"Phospholipid neutralization; hexagonal phospholipid","date_of_service":"2026-05-10","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":"73630","name":"X-ray exam of foot","description":"Radiologic examination, foot; complete, minimum of 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01842","name":"Anes art farm wrst&hnd emblc","description":"Anesthesia for procedures on arteries of forearm, wrist, and hand; embolectomy","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45126","name":"Pelvic exenteration","description":"Pelvic exenteration for colorectal malignancy, with proctectomy (with or without colostomy), with removal of bladder and ureteral transplantations, and/or hysterectomy, or cervicectomy, with or without removal of tube(s), with or without removal of ovary(s), or any combination thereof","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3021.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"57283","name":"Colpopexy intraperitoneal","description":"Colpopexy, vaginal; intra-peritoneal approach (uterosacral, levator myorrhaphy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35518","name":"Art byp grft axillary-axilry","description":"Bypass graft, with vein; axillary-axillary","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1656.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"78457","name":"Venous thrombosis imaging","description":"Venous thrombosis imaging, venogram; unilateral","date_of_service":"2026-05-10","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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":"64722","name":"Decompression unspec nerve","description":"Decompression; unspecified nerve(s) (specify)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61215","name":"Ins subq rsvr pmp/nfs sys","description":"Insertion of subcutaneous reservoir, pump or continuous infusion system for connection to ventricular catheter","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","date_of_service":"2026-05-10","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":"A4331","name":"Extension drainage tubing","description":"Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74328","name":"X-ray bile duct endoscopy","description":"Endoscopic catheterization of the biliary ductal system, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4931","name":"Reusable oral thermometer","description":"Oral thermometer, reusable, any type, each","date_of_service":"2026-05-10","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":"A7043","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73030","name":"X-ray exam of shoulder","description":"Radiologic examination, shoulder; complete, minimum of 2 views","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"25145","name":"Remove forearm bone lesion","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), forearm and/or wrist","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1343.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"78000","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"28208","name":"Repair of foot tendon","description":"Repair, tendon, extensor, foot; primary or secondary, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"48140","name":"Partial removal of pancreas","description":"Pancreatectomy, distal subtotal, with or without splenectomy; without pancreaticojejunostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"10040","name":"Extraction","description":"Extraction (eg, marsupialization, opening or removal of multiple milia, comedones, cysts, pustules)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"00524","name":"Anes clsd ch px pneumocents","description":"Anesthesia for closed chest procedures; pneumocentesis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"32310","name":"Removal of chest lining","description":"Pleurectomy, parietal (separate procedure)","date_of_service":"2026-05-10","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":"65785","name":"Impltj ntrstrml crnl rng seg","description":"Implantation of intrastromal corneal ring segments","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69710","name":"Implant/replace hearing aid","description":"Implantation or replacement of electromagnetic bone conduction hearing device in temporal bone","date_of_service":"2026-05-10","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":"77086","name":"Vrt fracture assmt via dxa","description":"Vertebral fracture assessment via dual-energy x-ray absorptiometry (dxa)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["TC"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"33973","name":"Insert balloon device","description":"Insertion of intra-aortic balloon assist device through the ascending aorta","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82232","name":"Assay of beta-2 protein","description":"Beta-2 microglobulin","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"49572","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86367","name":"Stem cells total count","description":"Stem cells (ie, cd34), total count","date_of_service":"2026-05-10","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":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":"01112","name":"Anes bone marrow aspir&/bx","description":"Anesthesia for bone marrow aspiration and/or biopsy, anterior or posterior iliac crest","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5828","name":"Endo knee-shin fluid swg/sta","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"P9040","name":"Rbc leukoreduced irradiated","description":"Red blood cells, leukocytes reduced, irradiated, each unit","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4244","name":"Alcohol or peroxide per pint","description":"Alcohol or peroxide, per pint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"T4527","name":"Adult size pull-on lg","description":"Adult sized disposable incontinence product, protective underwear/pull-on, large size, each","date_of_service":"2026-05-10","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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","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":"33236","name":"Remove electrode/thoracotomy","description":"Removal of permanent epicardial pacemaker and electrodes by thoracotomy; single lead system, atrial or ventricular","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":672.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":740.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86703","name":"Hiv-1/hiv-2 1 result antbdy","description":"Antibody; hiv-1 and hiv-2, single result","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27507","name":"Treatment of thigh fracture","description":"Open treatment of femoral shaft fracture with plate/screws, with or without cerclage","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"10007","name":"Fna bx w/fluor gdn 1st les","description":"Fine needle aspiration biopsy, including fluoroscopic guidance; first lesion","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"82985","name":"Assay of glycated protein","description":"Glycated protein","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"84392","name":"Assay of urine sulfate","description":"Sulfate, urine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4253","name":"Blood glucose/reagent strips","description":"Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1325.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74775","name":"X-ray exam of perineum","description":"Perineogram (eg, vaginogram, for sex determination or extent of anomalies)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["MS"]}],"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":"2026-05-10","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":"38505","name":"Needle biopsy lymph nodes","description":"Biopsy or excision of lymph node(s); by needle, superficial (eg, cervical, inguinal, axillary)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65130","name":"Insert ocular implant","description":"Insertion of ocular implant secondary; after evisceration, in scleral shell","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"90937","name":"Hemodialysis repeated eval","description":"Hemodialysis procedure requiring repeated evaluation(s) with or without substantial revision of dialysis prescription","date_of_service":"2026-05-10","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":"J1520","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2151.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0171","name":"Commode chair non-electric","description":"Commode chair with integrated seat lift mechanism, non-electric, any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"J2501","name":"Paricalcitol","description":"Injection, paricalcitol, 1 mcg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"66740","name":"Destruction ciliary body","description":"Ciliary body destruction; cyclodialysis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":873.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1237","name":"Rgd ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, rigid, adjustable, without seating system","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75945","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4435","name":"1pc ost pch drain hgh output","description":"Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"83500","name":"Assay free hydroxyproline","description":"Hydroxyproline; free","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"23920","name":"Disarticulation shoulder","description":"Disarticulation of shoulder;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":951.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47530","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","date_of_service":"2026-05-10","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":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","date_of_service":"2026-05-10","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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45309","name":"Proctosigmoidoscopy removal","description":"Proctosigmoidoscopy, rigid; with removal of single tumor, polyp, or other lesion by snare technique","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83570","name":"Assay of idh enzyme","description":"Isocitric dehydrogenase (idh)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":426.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4392","name":"Urinary pouch w st wear barr","description":"Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2341","name":"W/c wdth 24-27 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76775","name":"Us exam abdo back wall lim","description":"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0150","name":"Cerv semi-rig adj molded chn","description":"Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibular/occipital piece)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1712.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"82105","name":"Alpha-fetoprotein serum","description":"Alpha-fetoprotein (afp); serum","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82240","name":"Bile acids cholylglycine","description":"Bile acids; cholylglycine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"40810","name":"Excision of mouth lesion","description":"Excision of lesion of mucosa and submucosa, vestibule of mouth; without repair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00702","name":"Anes upr ant abd wall lvr bx","description":"Anesthesia for procedures on upper anterior abdominal wall; percutaneous liver biopsy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1002.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64907","name":"Nerve pedicle transfer","description":"Nerve pedicle transfer; second stage","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1567.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":566.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"A6254","name":"Absorpt drg <=16 sq in w/bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"48520","name":"Fuse pancreas cyst and bowel","description":"Internal anastomosis of pancreatic cyst to gastrointestinal tract; direct","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83930","name":"Assay of blood osmolality","description":"Osmolality; blood","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"84482","name":"T3 reverse","description":"Triiodothyronine t3; reverse","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82330","name":"Assay of calcium","description":"Calcium; ionized","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87250","name":"Virus inoculate eggs/animal","description":"Virus isolation; inoculation of embryonated eggs, or small animal, includes observation and dissection","date_of_service":"2026-05-10","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":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":"50715","name":"Release of ureter","description":"Ureterolysis, with or without repositioning of ureter for retroperitoneal fibrosis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1319.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1344.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72285","name":"Discography cerv/thor spine","description":"Discography, cervical or thoracic, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25825","name":"Arthrd wrist with autograft","description":"Arthrodesis, wrist; with autograft (includes obtaining graft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":645.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27165","name":"Incision/fixation of femur","description":"Osteotomy, intertrochanteric or subtrochanteric including internal or external fixation and/or cast","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1967.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":957.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93701","name":"Bioimpedance cv analysis","description":"Bioimpedance-derived physiologic cardiovascular analysis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","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":"55705","name":"Bx prst8 any approach nonimg","description":"Biopsy, prostate, any approach, nonimaging-guided","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"88108","name":"Cytopath concentrate tech","description":"Cytopathology, concentration technique, smears and interpretation (eg, saccomanno technique)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95813","name":"Eeg extnd mntr 61-119 min","description":"Electroencephalogram (eeg) extended monitoring; 61-119 minutes","date_of_service":"2026-05-10","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":"E0316","name":"Bed safety enclosure","description":"Safety enclosure frame/canopy for use with hospital bed, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46211","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0585","name":"Nebulizer w/ compressor & he","description":"Nebulizer, with compressor and heater","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"31225","name":"Removal of upper jaw","description":"Maxillectomy; without orbital exenteration","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24935","name":"Revision of amputation","description":"Stump elongation, upper extremity","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A6196","name":"Alginate dressing <=16 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1214.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84550","name":"Assay of blood/uric acid","description":"Uric acid; blood","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34421","name":"Removal of vein clot","description":"Thrombectomy, direct or with catheter; vena cava, iliac, femoropopliteal vein, by leg incision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"82803","name":"Blood gases any combination","description":"Gases, blood, any combination of ph, pco2, po2, co2, hco3 (including calculated o2 saturation);","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"24650","name":"Cltx rdl head/nck fx wo mnpj","description":"Closed treatment of radial head or neck fracture; without manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["TC"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78492","name":"Myocrd img pet mlt rst&strs","description":"Myocardial imaging, positron emission tomography (pet), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); multiple studies at rest and stress (exercise or pharmacologic)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2212","name":"Lens sphcyl bifo 7.25-12/2.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21401","name":"Closed tx orbit w/manipulj","description":"Closed treatment of fracture of orbit, except blowout; with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"90832","name":"Psytx w pt 30 minutes","description":"Psychotherapy, 30 minutes with patient","date_of_service":"2026-05-10","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":"91030","name":"Acid perfusion of esophagus","description":"Esophagus, acid perfusion (bernstein) test for esophagitis","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"83150","name":"Assay of homovanillic acid","description":"Homovanillic acid (hva)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93582","name":"Perq transcath closure pda","description":"Percutaneous transcatheter closure of patent ductus arteriosus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":712.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11960","name":"Insert tissue expander(s)","description":"Insertion of tissue expander(s) for other than breast, including subsequent expansion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":949.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"78609","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); perfusion evaluation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31640","name":"Bronchoscopy w/tumor excise","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with excision of tumor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","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":"43870","name":"Closure gastrostomy surgical","description":"Closure of gastrostomy, surgical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":688.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1377.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86590","name":"Streptokinase antibody","description":"Streptokinase, antibody","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3660","name":"So 8 ab rstr can/web pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":"57000","name":"Colpotomy w/exploration","description":"Colpotomy; with exploration","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73525","name":"Contrast x-ray of hip","description":"Radiologic examination, hip, arthrography, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75872","name":"Vein x-ray skull epidural","description":"Venography, epidural, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"76120","name":"Cine/video x-rays","description":"Cineradiography/videoradiography, except where specifically included","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"51725","name":"Simple cystometrogram","description":"Simple cystometrogram (cmg) (eg, spinal manometer)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19162","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":966.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26034","name":"Treat hand bone lesion","description":"Incision, bone cortex, hand or finger (eg, osteomyelitis or bone abscess)","date_of_service":"2026-05-10","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":"23415","name":"Release of shoulder ligament","description":"Coracoacromial ligament release, with or without acromioplasty","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75665","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":728.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42962","name":"Control throat bleeding","description":"Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); with secondary surgical intervention","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28341","name":"Resect enlarged toe","description":"Reconstruction, toe, macrodactyly; requiring bone resection","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-10","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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1274.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83885","name":"Assay of nickel","description":"Nickel","date_of_service":"2026-05-10","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":"37250","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"25924","name":"Amputation follow-up surgery","description":"Disarticulation through wrist; re-amputation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44227","name":"Lap close enterostomy","description":"Laparoscopy, surgical, closure of enterostomy, large or small intestine, with resection and anastomosis","date_of_service":"2026-05-10","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":"64752","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":550.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J8560","name":"Etoposide oral 50 mg","description":"Etoposide; oral, 50 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1975.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6586","name":"Elbow fair lead cable dir fo","description":"Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82145","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"53520","name":"Repair of urethra defect","description":"Closure of urethrostomy or urethrocutaneous fistula, male (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2810","name":"Inj theophylline per 40 mg","description":"Injection, theophylline, per 40 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"38505","name":"Needle biopsy lymph nodes","description":"Biopsy or excision of lymph node(s); by needle, superficial (eg, cervical, inguinal, axillary)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4614","name":"Hand-held pefr meter","description":"Peak expiratory flow rate meter, hand held","date_of_service":"2026-05-10","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":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"71034","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"48145","name":"Partial removal of pancreas","description":"Pancreatectomy, distal subtotal, with or without splenectomy; with pancreaticojejunostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1647.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","date_of_service":"2026-05-10","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":"35491","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E1230","name":"Power operated vehicle","description":"Power operated vehicle (three or four wheel nonhighway) specify brand name and model number","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1033.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2107.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00524","name":"Anes clsd ch px pneumocents","description":"Anesthesia for closed chest procedures; pneumocentesis","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2147.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91120","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01160","name":"Anes clsd px symph pub/si jt","description":"Anesthesia for closed procedures involving symphysis pubis or sacroiliac joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"L6940","name":"Elbow disarticulation switch","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64763","name":"Incise hip/thigh nerve","description":"Transection or avulsion of obturator nerve, extrapelvic, with or without adductor tenotomy","date_of_service":"2026-05-10","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":"37207","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2860","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21338","name":"Open nasoethmoid fx w/o fixj","description":"Open treatment of nasoethmoid fracture; without external fixation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"28345","name":"Repair webbed toe(s)","description":"Reconstruction, toe(s); syndactyly, with or without skin graft(s), each web","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1810","name":"Ko elastic with joints","description":"Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65235","name":"Remove foreign body from eye","description":"Removal of foreign body, intraocular; from anterior chamber of eye or lens","date_of_service":"2026-05-10","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":"88188","name":"Flowcytometry/read 9-15","description":"Flow cytometry, interpretation; 9 to 15 markers","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"92335","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"33891","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":856.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"00868","name":"Anes xtrprtl px rnl transpl","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; renal transplant (recipient)","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"73550","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"64712","name":"Revision of sciatic nerve","description":"Neuroplasty, major peripheral nerve, arm or leg, open; sciatic nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0486","name":"Tlso rigidlined cust fab two","description":"Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlappin","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67343","name":"Release eye tissue","description":"Release of extensive scar tissue without detaching extraocular muscle (separate procedure)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"47554","name":"Biliary endoscopy thru skin","description":"Biliary endoscopy, percutaneous via t-tube or other tract; with removal of calculus/calculi","date_of_service":"2026-05-10","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":"37600","name":"Ligation xtrnl carotid art","description":"Ligation; external carotid artery","date_of_service":"2026-05-10","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":"43263","name":"Ercp sphincter pressure meas","description":"Endoscopic retrograde cholangiopancreatography (ercp); with pressure measurement of sphincter of oddi","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70486","name":"Ct maxillofacial w/o dye","description":"Computed tomography, maxillofacial area; without contrast material","date_of_service":"2026-05-10","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":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KF"]}],"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":"2026-05-10","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":"52282","name":"Cystoscopy implant stent","description":"Cystourethroscopy, with insertion of permanent urethral stent","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"27816","name":"Treatment of ankle fracture","description":"Closed treatment of trimalleolar ankle fracture; without manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1199.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0840","name":"Tract frame attach headboard","description":"Traction frame, attached to headboard, cervical traction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"80100","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73085","name":"Contrast x-ray of elbow","description":"Radiologic examination, elbow, arthrography, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27041","name":"Biopsy of soft tissues","description":"Biopsy, soft tissue of pelvis and hip area; deep, subfascial or intramuscular","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1443.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"01962","name":"Anes urgent hysterectomy","description":"Anesthesia for urgent hysterectomy following delivery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78630","name":"Cerebrospinal fluid scan","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography","date_of_service":"2026-05-10","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":"56442","name":"Hymenotomy","description":"Hymenotomy, simple incision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"10081","name":"I&d pilonidal cyst comp","description":"Incision and drainage of pilonidal cyst; complicated","date_of_service":"2026-05-10","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":"93615","name":"Esophageal recording","description":"Esophageal recording of atrial electrogram with or without ventricular electrogram(s);","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25393","name":"Lengthen radius & ulna","description":"Osteoplasty, radius and ulna; lengthening with autograft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1083.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":321.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76873","name":"Echograp trans r pros study","description":"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01464","name":"Anes arthrs px ankle&/foot","description":"Anesthesia for arthroscopic procedures of ankle and/or foot","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78190","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82528","name":"Assay of corticosterone","description":"Corticosterone","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24200","name":"Rmvl fb upper arm/elbw subq","description":"Removal of foreign body, upper arm or elbow area; subcutaneous","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74450","name":"X-ray urethra/bladder","description":"Urethrocystography, retrograde, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62116","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1996.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J3370","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94680","name":"O2 uptk rst&xers dir simple","description":"Oxygen uptake, expired gas analysis; rest and exercise, direct, simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","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":"86609","name":"Bacterium antibody","description":"Antibody; bacterium, not elsewhere specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83014","name":"H pylori drug admin","description":"Helicobacter pylori; drug administration","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"64738","name":"Incision of jaw nerve","description":"Transection or avulsion of; inferior alveolar nerve by osteotomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92524","name":"Behavral qualit analys voice","description":"Behavioral and qualitative analysis of voice and resonance","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2207","name":"Lens sphcy bifocal 4.25-7d/.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":530.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31205","name":"Removal of ethmoid sinus","description":"Ethmoidectomy; extranasal, total","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1825","name":"Adjust finger ext & flex dev","description":"Dynamic adjustable finger extension and flexion device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00170","name":"Anes intraoral px nos","description":"Anesthesia for intraoral procedures, including biopsy; not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1377.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1681.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":856.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6384","name":"Postop dsg cast chg shlder/t","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1261.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23474","name":"Revis reconst shoulder joint","description":"Revision of total shoulder arthroplasty, including allograft when performed; humeral and glenoid component","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2153.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65765","name":"Keratophakia","description":"Keratophakia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96440","name":"Chmotx admn plrl cav thrcnts","description":"Chemotherapy administration into pleural cavity, requiring and including thoracentesis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6010","name":"Part hand little/ring","description":"Partial hand, little and/or ring finger remaining","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"65900","name":"Remove eye lesion","description":"Removal of epithelial downgrowth, anterior chamber of eye","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69601","name":"Revj mstdc rsltg compl mstdc","description":"Revision mastoidectomy; resulting in complete mastoidectomy","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":672.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2120","name":"Pulse gen sys tx endolymp fl","description":"Pulse generator system for tympanic treatment of inner ear endolymphatic fluid","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0464","name":"Tlso 4mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, corona","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"G6018","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27665","name":"Repair of leg tendon each","description":"Repair, extensor tendon, leg; secondary, with or without graft, each tendon","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":476.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"57250","name":"Repair rectum & vagina","description":"Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26476","name":"Tendon lengthening","description":"Lengthening of tendon, extensor, hand or finger, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":392.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5410","name":"Postop dsg bk ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28635","name":"Treat toe dislocation","description":"Closed treatment of metatarsophalangeal joint dislocation; requiring anesthesia","date_of_service":"2026-05-10","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":"88349","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","date_of_service":"2026-05-10","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":"J3302","name":"Triamcinolone diacetate inj","description":"Injection, triamcinolone diacetate, per 5 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59200","name":"Insert cervical dilator","description":"Insertion of cervical dilator (eg, laminaria, prostaglandin) (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94750","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84450","name":"Transferase (ast) (sgot)","description":"Transferase; aspartate amino (ast) (sgot)","date_of_service":"2026-05-10","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":"50970","name":"Ureter endoscopy","description":"Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"billing_code_modifier":["KE","NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33722","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"68550","name":"Remove tear gland lesion","description":"Excision of lacrimal gland tumor; involving osteotomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1129.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58925","name":"Removal of ovarian cyst(s)","description":"Ovarian cystectomy, unilateral or bilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":822.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1149.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"63190","name":"Incise spine nrv >2 segmnts","description":"Laminectomy with rhizotomy; more than 2 segments","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1402.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4015","name":"Cast sup gauntlet ped plster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), plaster","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"64472","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47760","name":"Fuse bile ducts and bowel","description":"Anastomosis, of extrahepatic biliary ducts and gastrointestinal tract","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"91022","name":"Duodenal motility study","description":"Duodenal motility (manometric) study","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63660","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"37720","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1478.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"19030","name":"Njx px only mam ducto/glcto","description":"Injection procedure only for mammary ductogram or galactogram","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26565","name":"Correct metacarpal flaw","description":"Osteotomy; metacarpal, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1037.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"33140","name":"Heart revascularize (tmr)","description":"Transmyocardial laser revascularization, by thoracotomy; (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1514.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP09","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":882.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E1060","name":"Wheelchair detachable arms","description":"Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"28112","name":"Part removal of metatarsal","description":"Ostectomy, complete excision; other metatarsal head (second, third or fourth)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-10","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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-10","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":"24110","name":"Exc/curtg b1 cst/b9 tum hum","description":"Excision or curettage of bone cyst or benign tumor, humerus;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82390","name":"Assay of ceruloplasmin","description":"Ceruloplasmin","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":653.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56700","name":"Prtl hymnctmy/revj hymnl rng","description":"Partial hymenectomy or revision of hymenal ring","date_of_service":"2026-05-10","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":"61514","name":"Crnec treph exc brn abs sttl","description":"Craniectomy, trephination, bone flap craniotomy; for excision of brain abscess, supratentorial","date_of_service":"2026-05-10","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":"29086","name":"Application cast finger","description":"Application, cast; finger (eg, contracture)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93770","name":"Determination venous press","description":"Determination of venous pressure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"75891","name":"Vein x-ray liver","description":"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"33511","name":"Cabg vein two","description":"Coronary artery bypass, vein only; 2 coronary venous grafts","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29450","name":"Application clubfoot cast","description":"Application of clubfoot cast with molding or manipulation, long or short leg","date_of_service":"2026-05-10","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":"35490","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"92544","name":"Optokinetic nystagmus test","description":"Optokinetic nystagmus test, bidirectional, foveal or peripheral stimulation, with recording","date_of_service":"2026-05-10","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":"69150","name":"Extensive ear canal surgery","description":"Radical excision external auditory canal lesion; without neck dissection","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"47630","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94610","name":"Intrapulm surfactant admn","description":"Intrapulmonary surfactant administration by a physician or other qualified health care professional through endotracheal tube","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":994.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2225.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00950","name":"Anes vag px culdoscopy","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); culdoscopy","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2213","name":"Lens sphcyl bifo 7.25-12/4.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-10","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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","date_of_service":"2026-05-10","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":"23450","name":"Repair shoulder capsule","description":"Capsulorrhaphy, anterior; putti-platt procedure or magnuson type operation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-05-10","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":"54430","name":"Revision of penis","description":"Corpora cavernosa-corpus spongiosum shunt (priapism operation), unilateral or bilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99321","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1887","name":"Catheter, guiding","description":"Catheter, guiding (may include infusion/perfusion capability)","date_of_service":"2026-05-10","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":"93042","name":"Rhythm ecg report","description":"Rhythm ecg, 1-3 leads; interpretation and report only","date_of_service":"2026-05-10","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":"01464","name":"Anes arthrs px ankle&/foot","description":"Anesthesia for arthroscopic procedures of ankle and/or foot","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3222.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":930.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76965","name":"Echo guidance radiotherapy","description":"Ultrasonic guidance for interstitial radioelement application","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76812","name":"Ob us detailed addl fetus","description":"Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal anatomic examination, transabdominal approach; each additional gestation (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38790","name":"Inject for lymphatic x-ray","description":"Injection procedure; lymphangiography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":"68550","name":"Remove tear gland lesion","description":"Excision of lacrimal gland tumor; involving osteotomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2416.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93888","name":"Intracranial limited study","description":"Transcranial doppler study of the intracranial arteries; limited study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1804.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"95943","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"47480","name":"Incision of gallbladder","description":"Cholecystotomy or cholecystostomy, open, with exploration, drainage, or removal of calculus (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6453","name":"Self-adher band w <3in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"95975","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1867.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-05-10","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":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2349.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22015","name":"I&d abscess p-spine l/s/ls","description":"Incision and drainage, open, of deep abscess (subfascial), posterior spine; lumbar, sacral, or lumbosacral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":981.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00906","name":"Anes vulvectomy","description":"Anesthesia for; vulvectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92577","name":"Stenger test speech","description":"Stenger test, speech","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"31030","name":"Exploration maxillary sinus","description":"Sinusotomy, maxillary (antrotomy); radical (caldwell-luc) without removal of antrochoanal polyps","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0146T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69930","name":"Implant cochlear device","description":"Cochlear device implantation, with or without mastoidectomy","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"95867","name":"Ndl emg cranial nrv musc uni","description":"Needle electromyography; cranial nerve supplied muscle(s), unilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"G0452","name":"Molecular pathology interpr","description":"Molecular pathology procedure; physician interpretation and report","date_of_service":"2026-05-10","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":"A4402","name":"Lubricant per ounce","description":"Lubricant, per ounce","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"25450","name":"Epiphysl arrst dstl rds/ulna","description":"Epiphyseal arrest by epiphysiodesis or stapling; distal radius or ulna","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"77326","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"00916","name":"Anes trurl px rescj bleeding","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); post-transurethral resection bleeding","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":627.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"75722","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1755","name":"Legg perthes patten bottom t","description":"Legg perthes orthosis, (patten bottom type), custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1816.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54250","name":"Nctrnl pen tmscn&/rgdity tst","description":"Nocturnal penile tumescence and/or rigidity test","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-10","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":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86486","name":"Skin test unlisted antign ea","description":"Skin test; unlisted antigen, each","date_of_service":"2026-05-10","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":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"90680","name":"Rv5 vacc 3 dose live oral","description":"Rotavirus vaccine, pentavalent (rv5), 3 dose schedule, live, for oral use","date_of_service":"2026-05-10","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":116.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2126","name":"Kafo fem fx cast thermoplas","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"88356","name":"Analysis nerve","description":"Morphometric analysis; nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1451","name":"Fomepizole, 15 mg","description":"Injection, fomepizole, 15 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3981","name":"Ue fx orth shoul cap forearm","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1533.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3764","name":"Ewho w/joint(s) cf","description":"Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1826.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7511","name":"Antithymocyte globuln rabbit","description":"Lymphocyte immune globulin, antithymocyte globulin, rabbit, parenteral, 25 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0632","name":"Lso sag rigid frame cust","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-10","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":"15922","name":"Exc coccygl pr ulc flap clsr","description":"Excision, coccygeal pressure ulcer, with coccygectomy; with flap closure","date_of_service":"2026-05-10","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":"82480","name":"Assay serum cholinesterase","description":"Cholinesterase; serum","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87169","name":"Macroscopic exam parasite","description":"Macroscopic examination; parasite","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00630","name":"Anes px lumbar region nos","description":"Anesthesia for procedures in lumbar region; not otherwise specified","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99211","name":"Off/op est may x req phy/qhp","description":"Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician or other qualified health care professional","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2289.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-10","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":"A4435","name":"1pc ost pch drain hgh output","description":"Ostomy pouch, drainable, high output, with extended wear barrier (one-piece system), with or without filter, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57010","name":"Colpotomy drg pel abscess","description":"Colpotomy; with drainage of pelvic abscess","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"70371","name":"Speech evaluation complex","description":"Complex dynamic pharyngeal and speech evaluation by cine or video recording","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1091.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"24331","name":"Flexor-plasty elbw w/advmnt","description":"Flexor-plasty, elbow (eg, steindler type advancement); with extensor advancement","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":962.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90687","name":"Iiv4 vaccine splt 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","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":10.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"70390","name":"X-ray exam of salivary duct","description":"Sialography, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27334","name":"Remove knee joint lining","description":"Arthrotomy, with synovectomy, knee; anterior or posterior","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1630","name":"Abduct control hip semi-flex","description":"Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00126","name":"Anes px ear tympanotomy","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; tympanotomy","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1371.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7507","name":"Tacrolimus imme rel oral 1mg","description":"Tacrolimus, immediate release, oral, 1 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"E1190","name":"Wheelchair amputee w/ leg re","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable elevating legrests","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27429","name":"Reconstruction knee","description":"Ligamentous reconstruction (augmentation), knee; intra-articular (open) and extra-articular","date_of_service":"2026-05-10","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":"44500","name":"Intro gastrointestinal tube","description":"Introduction of long gastrointestinal tube (eg, miller-abbott) (separate procedure)","date_of_service":"2026-05-10","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":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":957.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"72240","name":"Myelography neck spine","description":"Myelography, cervical, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"82135","name":"Assay aminolevulinic acid","description":"Aminolevulinic acid, delta (ala)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"42426","name":"Excise parotid gland/lesion","description":"Excision of parotid tumor or parotid gland; total, with unilateral radical neck dissection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1602.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"82415","name":"Assay of chloramphenicol","description":"Chloramphenicol","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1353","name":"Oxygen supplies regulator","description":"Regulator","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5504","name":"Diabetic shoe with wedge","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"59812","name":"Treatment of miscarriage","description":"Treatment of incomplete abortion, any trimester, completed surgically","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-10","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":"57308","name":"Fistula repair transperine","description":"Closure of rectovaginal fistula; transperineal approach, with perineal body reconstruction, with or without levator plication","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1831","name":"Static str toe dev ext/flex","description":"Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47550","name":"Bile duct endoscopy add-on","description":"Biliary endoscopy, intraoperative (choledochoscopy) (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78461","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"82374","name":"Assay blood carbon dioxide","description":"Carbon dioxide (bicarbonate)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":964.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0437","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"32607","name":"Thoracoscopy w/bx infiltrate","description":"Thoracoscopy; with diagnostic biopsy(ies) of lung infiltrate(s) (eg, wedge, incisional), unilateral","date_of_service":"2026-05-10","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":"E1228","name":"Wheelchair spec sz spec ht b","description":"Special back height for wheelchair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33420","name":"Revision of mitral valve","description":"Valvotomy, mitral valve; closed heart","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"A4649","name":"Surgical supplies","description":"Surgical supply; miscellaneous","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":467.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4206","name":"1 cc sterile syringe&needle","description":"Syringe with needle, sterile, 1 cc or less, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L8415","name":"Sheath upper limb","description":"Prosthetic sheath, upper limb, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"72040","name":"X-ray exam neck spine 2-3 vw","description":"Radiologic examination, spine, cervical; 2 or 3 views","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","date_of_service":"2026-05-10","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":"86744","name":"Nocardia antibody","description":"Antibody; nocardia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L2034","name":"Kafo pla sin up w/wo k/a cus","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"23931","name":"I&d upr a/e bursa","description":"Incision and drainage, upper arm or elbow area; bursa","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65235","name":"Remove foreign body from eye","description":"Removal of foreign body, intraocular; from anterior chamber of eye or lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75953","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44389","name":"Colonoscopy with biopsy","description":"Colonoscopy through stoma; with biopsy, single or multiple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"70120","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; less than 3 views per side","date_of_service":"2026-05-10","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":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","date_of_service":"2026-05-10","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":"01150","name":"Anes rad px tumor of pelvis","description":"Anesthesia for radical procedures for tumor of pelvis, except hindquarter amputation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"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":"95865","name":"Needle emg larynx","description":"Needle electromyography; larynx","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7506","name":"Hmes/trachvalve adhesivedisk","description":"Adhesive disc for use in a heat and moisture exchange system and/or with tracheostoma valve, any type each","date_of_service":"2026-05-10","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":"28315","name":"Removal of sesamoid bone","description":"Sesamoidectomy, first toe (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64517","name":"N block inj hypogas plxs","description":"Injection, anesthetic agent; superior hypogastric plexus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"A4411","name":"Ost skn barr extnd =4sq","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"51520","name":"Removal of bladder lesion","description":"Cystotomy; for simple excision of vesical neck (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":481.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25393","name":"Lengthen radius & ulna","description":"Osteoplasty, radius and ulna; lengthening with autograft","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5840","name":"Multi-axial knee/shin system","description":"Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1800","name":"Adjust elbow ext & flex dev","description":"Dynamic adjustable elbow extension and flexion device, includes soft interface material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","date_of_service":"2026-05-10","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":"50728","name":"Revise ureter","description":"Revision of urinary-cutaneous anastomosis (any type urostomy); with repair of fascial defect and hernia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-10","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":"00872","name":"Anes lithotrp esw water bath","description":"Anesthesia for lithotripsy, extracorporeal shock wave; with water bath","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"92614","name":"Laryngoscopic sensory vid","description":"Flexible endoscopic evaluation, laryngeal sensory testing by cine or video recording;","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6229","name":"Gauze >16<=48 sq in watr/sal","description":"Gauze, impregnated, water or normal saline, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"L1510","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-10","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":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28306","name":"Incision of metatarsal","description":"Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; first metatarsal","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"62252","name":"Csf shunt reprogram","description":"Reprogramming of programmable cerebrospinal shunt","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28072","name":"Removal of foot joint lining","description":"Synovectomy; metatarsophalangeal joint, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63615","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90901","name":"Biofeedback train any meth","description":"Biofeedback training by any modality","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1270","name":"Wheelchair lightweight leg r","description":"Lightweight wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-05-10","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":"54110","name":"Treatment of penis lesion","description":"Excision of penile plaque (peyronie disease);","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":886.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0948","name":"Fracture frame attachmnts ce","description":"Fracture frame, attachments for complex cervical traction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0516","name":"Insert drug del implant, >=4","description":"Insertion of non-biodegradable drug delivery implants, 4 or more (services for subdermal rod implant)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"J1815","name":"Insulin injection","description":"Injection, insulin, per 5 units","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"20808","name":"Replantation hand complete","description":"Replantation, hand (includes hand through metacarpophalangeal joints), complete amputation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4959.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"72198","name":"Mr angio pelvis w/o & w/dye","description":"Magnetic resonance angiography, pelvis, with or without contrast material(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83631","name":"Lactoferrin fecal (quant)","description":"Lactoferrin, fecal; quantitative","date_of_service":"2026-05-10","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":"95117","name":"Immunotherapy injections","description":"Professional services for allergen immunotherapy not including provision of allergenic extracts; 2 or more injections","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","date_of_service":"2026-05-10","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":"61526","name":"Removal of brain lesion","description":"Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of cerebellopontine angle tumor;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3968.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"C1751","name":"Cath, inf, per/cent/midline","description":"Catheter, infusion, inserted peripherally, centrally or midline (other than hemodialysis)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3901","name":"Hinge ext/flex wrist finger","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94350","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","date_of_service":"2026-05-10","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":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25355","name":"Revision of radius","description":"Osteotomy, radius; middle or proximal third","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":512.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"47135","name":"Transplantation of liver","description":"Liver allotransplantation, orthotopic, partial or whole, from cadaver or living donor, any age","date_of_service":"2026-05-10","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":"93526","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2923.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2474.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01842","name":"Anes art farm wrst&hnd emblc","description":"Anesthesia for procedures on arteries of forearm, wrist, and hand; embolectomy","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1492.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32019","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"58321","name":"Artificial insemination","description":"Artificial insemination; intra-cervical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72292","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"00218","name":"Anes icr px in sitting pos","description":"Anesthesia for intracranial procedures; procedures in sitting position","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92135","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3674","name":"So airplane w/wo joint cf","description":"Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0740","name":"Non-implant pelv flr e-stim","description":"Non-implanted pelvic floor electrical stimulator, complete system","date_of_service":"2026-05-10","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":"86147","name":"Cardiolipin antibody ea ig","description":"Cardiolipin (phospholipid) antibody, each ig class","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"54840","name":"Remove epididymis lesion","description":"Excision of spermatocele, with or without epididymectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"L3969","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99202","name":"Office o/p new sf 15 min","description":"Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. when using total time on the date of the encounter for code selection, 15 minutes must be met or exceede","date_of_service":"2026-05-10","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":"35691","name":"Art trnsposj vertbrl carotid","description":"Transposition and/or reimplantation; vertebral to carotid artery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1302.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80154","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KM"]}],"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":"2026-05-10","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":"76705","name":"Echo exam of abdomen","description":"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88375","name":"Optical endomicroscpy interp","description":"Optical endomicroscopic image(s), interpretation and report, real-time or referred, each endoscopic session","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43632","name":"Removal of stomach partial","description":"Gastrectomy, partial, distal; with gastrojejunostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"39545","name":"Revision of diaphragm","description":"Imbrication of diaphragm for eventration, transthoracic or transabdominal, paralytic or nonparalytic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1020.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53275","name":"Repair of urethra defect","description":"Excision or fulguration; urethral prolapse","date_of_service":"2026-05-10","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":"E0779","name":"Amb infusion pump mechanical","description":"Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"57292","name":"Construct vagina with graft","description":"Construction of artificial vagina; with graft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33736","name":"Revision of heart chamber","description":"Atrial septectomy or septostomy; open heart with cardiopulmonary bypass","date_of_service":"2026-05-10","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":"29435","name":"Appl patllr tdn bearing cast","description":"Application of patellar tendon bearing (ptb) cast","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"78278","name":"Acute gi blood loss imaging","description":"Acute gastrointestinal blood loss imaging","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1925.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2250","name":"Remot img sub by pt, non e/m","description":"Remote assessment of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related service provided within the previous 7 days nor leading to a service or p","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33140","name":"Heart revascularize (tmr)","description":"Transmyocardial laser revascularization, by thoracotomy; (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1353.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35511","name":"Art byp grft subclav-subclav","description":"Bypass graft, with vein; subclavian-subclavian","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1488.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"19300","name":"Mastectomy for gynecomastia","description":"Mastectomy for gynecomastia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99339","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"19364","name":"Brst rcnstj free flap","description":"Breast reconstruction; with free flap (eg, ftram, diep, siea, gap flap)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1780.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"21025","name":"Excision of bone lower jaw","description":"Excision of bone (eg, for osteomyelitis or bone abscess); mandible","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":940.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":806.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26560","name":"Repair of web finger","description":"Repair of syndactyly (web finger) each web space; with skin flaps","date_of_service":"2026-05-10","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":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"94370","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1326.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75731","name":"Artery x-rays adrenal gland","description":"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92070","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"66225","name":"Repair/graft eye lesion","description":"Repair of scleral staphyloma with graft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77408","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1815.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36819","name":"Av fuse uppr arm basilic","description":"Arteriovenous anastomosis, open; by upper arm basilic vein transposition","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39000","name":"Exploration of chest","description":"Mediastinotomy with exploration, drainage, removal of foreign body, or biopsy; cervical approach","date_of_service":"2026-05-10","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":"31535","name":"Laryngoscopy w/biopsy","description":"Laryngoscopy, direct, operative, with biopsy;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"78650","name":"Csf leakage imaging","description":"Cerebrospinal fluid leakage detection and localization","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78466","name":"Heart infarct image","description":"Myocardial imaging, infarct avid, planar; qualitative or quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","date_of_service":"2026-05-10","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":"00904","name":"Anes radical perineal px","description":"Anesthesia for; radical perineal procedure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"83037","name":"Hb glycosylated a1c home dev","description":"Hemoglobin; glycosylated (a1c) by device cleared by fda for home use","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38740","name":"Remove armpit lymph nodes","description":"Axillary lymphadenectomy; superficial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"G0120","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","date_of_service":"2026-05-10","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":"95865","name":"Needle emg larynx","description":"Needle electromyography; larynx","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"E0731","name":"Conductive garment for tens/","description":"Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patients skin by layers of fabric)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28280","name":"Fusion of toes","description":"Syndactylization, toes (eg, webbing or kelikian type procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33925","name":"Rpr pul art unifocal w/o cpb","description":"Repair of pulmonary artery arborization anomalies by unifocalization; without cardiopulmonary bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2200.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2269.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5505","name":"Init ak ischal plstr direct","description":"Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26490","name":"Revise thumb tendon","description":"Opponensplasty; superficialis tendon transfer type, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1033.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76362","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"61516","name":"Crnec treph exc cyst sttl","description":"Craniectomy, trephination, bone flap craniotomy; for excision or fenestration of cyst, supratentorial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"99185","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J1580","name":"Garamycin gentamicin inj","description":"Injection, garamycin, gentamicin, up to 80 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1378.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["TC"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86356","name":"Mononuclear cell antigen","description":"Mononuclear cell antigen, quantitative (eg, flow cytometry), not otherwise specified, each antigen","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43255","name":"Egd control bleeding any","description":"Esophagogastroduodenoscopy, flexible, transoral; with control of bleeding, any method","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":875.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19328","name":"Rmvl intact breast implant","description":"Removal of intact breast implant","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82157","name":"Assay of androstenedione","description":"Androstenedione","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"82247","name":"Bilirubin total","description":"Bilirubin; total","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1227.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":838.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85400","name":"Fibrinolytic plasmin","description":"Fibrinolytic factors and inhibitors; plasmin","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"74445","name":"X-ray exam of penis","description":"Corpora cavernosography, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"95900","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"67414","name":"Explr/decompress eye socket","description":"Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of bone for decompression","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":845.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q0486","name":"Mon cable elec/pneum vad rep","description":"Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1405","name":"O2/water vapor enrich w/heat","description":"Oxygen and water vapor enriching system with heated delivery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43210","name":"Egd esophagogastrc fndoplsty","description":"Esophagogastroduodenoscopy, flexible, transoral; with esophagogastric fundoplasty, partial or complete, includes duodenoscopy when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"90857","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":817.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"91200","name":"Liver elastography","description":"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["26"]}],"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":"2026-05-10","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":"L6621","name":"Flex/ext wrist w/wo friction","description":"Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1055.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"78456","name":"Acute venous thrombus image","description":"Acute venous thrombosis imaging, peptide","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1397.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49505","name":"Prp i/hern init reduc >5 yr","description":"Repair initial inguinal hernia, age 5 years or older; reducible","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"L1834","name":"Ko w/0 joint rigid molded to","description":"Knee orthosis, without knee joint, rigid, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29899","name":"Ankle arthroscopy/surgery","description":"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; with ankle arthrodesis","date_of_service":"2026-05-10","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":"83633","name":"Test urine for lactose","description":"Lactose, urine, qualitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1227","name":"Wheelchair spec sz spec ht a","description":"Special height arms for wheelchair","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"33647","name":"Repair heart septum defects","description":"Repair of atrial septal defect and ventricular septal defect, with direct or patch closure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2031.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"57555","name":"Remove cervix/repair vagina","description":"Excision of cervical stump, vaginal approach; with anterior and/or posterior repair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":675.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"27086","name":"Remove hip foreign body","description":"Removal of foreign body, pelvis or hip; subcutaneous tissue","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0447T","name":"Rmvl impltbl glucose sensor","description":"Removal of implantable interstitial glucose sensor from subcutaneous pocket via incision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62116","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1386.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"24640","name":"Cltx rdl head sublxtj nrsemd","description":"Closed treatment of radial head subluxation in child, nursemaid elbow, with manipulation","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26510","name":"Thumb tendon transfer","description":"Cross intrinsic transfer, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67912","name":"Correction eyelid w/implant","description":"Correction of lagophthalmos, with implantation of upper eyelid lid load (eg, gold weight)","date_of_service":"2026-05-10","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":"92235","name":"Fluorescein angrph mltiframe","description":"Fluorescein angiography (includes multiframe imaging) with interpretation and report, unilateral or bilateral","date_of_service":"2026-05-10","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":"54055","name":"Destruction penis lesion(s)","description":"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; electrodesiccation","date_of_service":"2026-05-10","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":"29906","name":"Subtalar arthro w/deb","description":"Arthroscopy, subtalar joint, surgical; with debridement","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":646.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24346","name":"Reconstruct elbow med ligmnt","description":"Reconstruction medial collateral ligament, elbow, with tendon graft (includes harvesting of graft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40812","name":"Excise/repair mouth lesion","description":"Excision of lesion of mucosa and submucosa, vestibule of mouth; with simple repair","date_of_service":"2026-05-10","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":"93025","name":"Microvolt t-wave assess","description":"Microvolt t-wave alternans for assessment of ventricular arrhythmias","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64430","name":"Njx aa&/strd pudendal nerve","description":"Injection(s), anesthetic agent(s) and/or steroid; pudendal nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-10","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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1201.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4266","name":"Diaphragm","description":"Diaphragm for contraceptive use","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27466","name":"Lengthening of thigh bone","description":"Osteoplasty, femur; lengthening","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3235.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86622","name":"Brucella antibody","description":"Antibody; brucella","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97026","name":"Infrared therapy","description":"Application of a modality to 1 or more areas; infrared","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95869","name":"Ndl emg thrc paraspinal musc","description":"Needle electromyography; thoracic paraspinal muscles (excluding t1 or t12)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1279.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1798.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":768.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"59866","name":"Abortion (mpr)","description":"Multifetal pregnancy reduction(s) (mpr)","date_of_service":"2026-05-10","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":"55840","name":"Extensive prostate surgery","description":"Prostatectomy, retropubic radical, with or without nerve sparing;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":947.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35482","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"64734","name":"Incision of cheek nerve","description":"Transection or avulsion of; infraorbital nerve","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0606","name":"Drainage board postural","description":"Postural drainage board","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"84165","name":"Protein e-phoresis serum","description":"Protein; electrophoretic fractionation and quantitation, serum","date_of_service":"2026-05-10","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":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92980","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"28193","name":"Removal of foot foreign body","description":"Removal of foreign body, foot; complicated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L0468","name":"Tlso rig fram pelvic pre cst","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal, and coronal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"73565","name":"X-ray exam of knees","description":"Radiologic examination, knee; both knees, standing, anteroposterior","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"68816","name":"Probe nl duct w/balloon","description":"Probing of nasolacrimal duct, with or without irrigation; with transluminal balloon catheter dilation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"0245T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1303.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5826","name":"Miniature knee joint","description":"Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3977","name":"Sewhfo cap desgn w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":833.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27606","name":"Incision of achilles tendon","description":"Tenotomy, percutaneous, achilles tendon (separate procedure); general anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1847","name":"Ko dbl upright w/air pre cst","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58350","name":"Reopen fallopian tube","description":"Chromotubation of oviduct, including materials","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"15175","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":529.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90715","name":"Tdap vaccine 7 yrs/> im","description":"Tetanus, diphtheria toxoids and acellular pertussis vaccine (tdap), when administered to individuals 7 years or older, for intramuscular use","date_of_service":"2026-05-10","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":39.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"88182","name":"Cell marker study","description":"Flow cytometry, cell cycle or dna analysis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1227.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31050","name":"Exploration sphenoid sinus","description":"Sinusotomy, sphenoid, with or without biopsy;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52332","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with insertion of indwelling ureteral stent (eg, gibbons or double-j type)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"65436","name":"Curette/treat cornea","description":"Removal of corneal epithelium; with application of chelating agent (eg, edta)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28240","name":"Release of big toe","description":"Tenotomy, lengthening, or release, abductor hallucis muscle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"70030","name":"X-ray eye for foreign body","description":"Radiologic examination, eye, for detection of foreign body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":829.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"24332","name":"Tenolysis triceps","description":"Tenolysis, triceps","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24343","name":"Repr elbow lat ligmnt w/tiss","description":"Repair lateral collateral ligament, elbow, with local tissue","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":832.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1357.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11901","name":"Inject skin lesions >7","description":"Injection, intralesional; more than 7 lesions","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"29220","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2180","name":"Plas shoe insert w ank joint","description":"Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints","date_of_service":"2026-05-10","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":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0495","name":"Charger elec/combo vad, rep","description":"Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"Q9954","name":"Oral mr contrast, 100 ml","description":"Oral magnetic resonance contrast agent, per 100 ml","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38232","name":"Bone marrow harvest autolog","description":"Bone marrow harvesting for transplantation; autologous","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1832","name":"Ko adj jnt pos r sup pre cst","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1812","name":"Knee ext/flex w act res ctrl","description":"Dynamic knee, extension/flexion device with active resistance control","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75810","name":"Vein x-ray spleen/liver","description":"Splenoportography, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35400","name":"Angioscopy","description":"Angioscopy (noncoronary vessels or grafts) during therapeutic intervention (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"32124","name":"Explore chest free adhesions","description":"Thoracotomy; with open intrapleural pneumonolysis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":981.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84443","name":"Assay thyroid stim hormone","description":"Thyroid stimulating hormone (tsh)","date_of_service":"2026-05-10","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":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27110","name":"Transfer of iliopsoas muscle","description":"Transfer iliopsoas; to greater trochanter of femur","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1109.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37202","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76700","name":"Us exam abdom complete","description":"Ultrasound, abdominal, real time with image documentation; complete","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":835.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72129","name":"Ct chest spine w/dye","description":"Computed tomography, thoracic spine; with contrast material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6556","name":"G com stcking thgh18-30 cust","description":"Gradient compression stocking, thigh length, 18-30 mmhg, custom, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"65855","name":"Trabeculoplasty laser surg","description":"Trabeculoplasty by laser surgery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1145.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","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":"88346","name":"Imfluor 1st 1antb stain px","description":"Immunofluorescence, per specimen; initial single antibody stain procedure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97012","name":"Mechanical traction therapy","description":"Application of a modality to 1 or more areas; traction, mechanical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50900","name":"Repair of ureter","description":"Ureterorrhaphy, suture of ureter (separate procedure)","date_of_service":"2026-05-10","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":"77262","name":"Ther radiology tx plng intrm","description":"Therapeutic radiology treatment planning; intermediate","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"43648","name":"Lap revise/remv eltrd antrum","description":"Laparoscopy, surgical; revision or removal of gastric neurostimulator electrodes, antrum","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":689.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75961","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","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":"77620","name":"Hyperthermia gen intrcv prb","description":"Hyperthermia generated by intracavitary probe(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28735","name":"Fusion of foot bones","description":"Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse; with osteotomy (eg, flatfoot correction)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":923.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KC"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5695","name":"Ak sleeve susp neoprene/equa","description":"Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9260","name":"Inj methotrexate sodium 50mg","description":"Injection, methotrexate sodium, 50 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2306","name":"Lens sphcyl trifocal 4.00/>6","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"75810","name":"Vein x-ray spleen/liver","description":"Splenoportography, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"J9211","name":"Idarubicin hcl injection","description":"Injection, idarubicin hydrochloride, 5 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26261","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27448","name":"Incision of thigh","description":"Osteotomy, femur, shaft or supracondylar; without fixation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":694.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","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":"28261","name":"Revision of foot tendon","description":"Capsulotomy, midfoot; with tendon lengthening","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33031","name":"Partial removal of heart sac","description":"Pericardiectomy, subtotal or complete; with cardiopulmonary bypass","date_of_service":"2026-05-10","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":"30115","name":"Removal of nose polyp(s)","description":"Excision, nasal polyp(s), extensive","date_of_service":"2026-05-10","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":"J1956","name":"Levofloxacin injection","description":"Injection, levofloxacin, 250 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":510.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6229","name":"Gauze >16<=48 sq in watr/sal","description":"Gauze, impregnated, water or normal saline, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","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":"44187","name":"Lap ileo/jejuno-stomy","description":"Laparoscopy, surgical; ileostomy or jejunostomy, non-tube","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31624","name":"Dx bronchoscope/lavage","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial alveolar lavage","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KC"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"73521","name":"X-ray exam hips bi 2 views","description":"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views","date_of_service":"2026-05-10","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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-10","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":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":775.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"01112","name":"Anes bone marrow aspir&/bx","description":"Anesthesia for bone marrow aspiration and/or biopsy, anterior or posterior iliac crest","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","date_of_service":"2026-05-10","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":"87277","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2961.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"86305","name":"Human epididymis protein 4","description":"Human epididymis protein 4 (he4)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"91200","name":"Liver elastography","description":"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"40830","name":"Repair mouth laceration","description":"Closure of laceration, vestibule of mouth; 2.5 cm or less","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"ATP16","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"86256","name":"Fluorescent antibody titer","description":"Fluorescent noninfectious agent antibody; titer, each antibody","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75807","name":"Lymph vessel x-ray trunk","description":"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29875","name":"Arthrs knee surg synvct lmtd","description":"Arthroscopy, knee, surgical; synovectomy, limited (eg, plica or shelf resection) (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"68115","name":"Exc les conjunctiva >1 cm","description":"Excision of lesion, conjunctiva; over 1 cm","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"90651","name":"9vhpv vaccine 2/3 dose im","description":"Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent (9vhpv), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","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":375.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1538.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2645.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":931.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":997.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G6013","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-10","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":"94375","name":"Respiratory flow volume loop","description":"Respiratory flow volume loop","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0633","name":"Lso sc r pos/lat pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65805","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15170","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","date_of_service":"2026-05-10","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":"32522","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1773.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4311","name":"Catheter w/o bag 2-way latex","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70190","name":"X-ray exam of eye sockets","description":"Radiologic examination; optic foramina","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80178","name":"Assay of lithium","description":"Lithium","date_of_service":"2026-05-10","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":"01200","name":"Anes all closed px hip joint","description":"Anesthesia for all closed procedures involving hip joint","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26700","name":"Treat knuckle dislocation","description":"Closed treatment of metacarpophalangeal dislocation, single, with manipulation; without anesthesia","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67250","name":"Reinforce eye wall","description":"Scleral reinforcement (separate procedure); without graft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36415","name":"Coll venous bld venipuncture","description":"Collection of venous blood by venipuncture","date_of_service":"2026-05-10","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":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"33496","name":"Repair prosth valve clot","description":"Repair of non-structural prosthetic valve dysfunction with cardiopulmonary bypass (separate procedure)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"96446","name":"Chemotx admn pertl cav impl","description":"Chemotherapy administration into the peritoneal cavity via implanted port or catheter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86682","name":"Helminth antibody","description":"Antibody; helminth, not elsewhere specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"97024","name":"Diathermy eg microwave","description":"Application of a modality to 1 or more areas; diathermy (eg, microwave)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"61550","name":"Release of skull seams","description":"Craniectomy for craniosynostosis; single cranial suture","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1348.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"G0127","name":"Trim nail(s)","description":"Trimming of dystrophic nails, any number","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88107","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7509","name":"Heat & moisture exchange sys","description":"Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-10","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":"80178","name":"Assay of lithium","description":"Lithium","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-05-10","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":"78606","name":"Brain image w/flow 4 + views","description":"Brain imaging, minimum 4 static views; with vascular flow","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","date_of_service":"2026-05-10","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":"E0217","name":"Water circ heat pad w pump","description":"Water circulating heat pad with pump","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0878","name":"Daptomycin injection","description":"Injection, daptomycin, 1 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KM"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58572","name":"Tlh uterus over 250 g","description":"Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65205","name":"Remove foreign body from eye","description":"Removal of foreign body, external eye; conjunctival superficial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"00920","name":"Anes px male genitalia nos","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); not otherwise specified","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1069.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34804","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45398","name":"Colonoscopy w/band ligation","description":"Colonoscopy, flexible; with band ligation(s) (eg, hemorrhoids)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86860","name":"Rbc antibody elution","description":"Antibody elution (rbc), each elution","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":786.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3917","name":"Metacarp fx orthosis pre cst","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2399.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8606","name":"Synthetic implnt urinary 1ml","description":"Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"E2343","name":"W/c dpth 22-25 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"E0220","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"01214","name":"Anes open px tot hip arthrp","description":"Anesthesia for open procedures involving hip joint; total hip arthroplasty","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25390","name":"Shorten radius or ulna","description":"Osteoplasty, radius or ulna; shortening","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1226.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"85362","name":"Fibrin degradation products","description":"Fibrin(ogen) degradation (split) products (fdp) (fsp); agglutination slide, semiquantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95822","name":"Eeg coma or sleep only","description":"Electroencephalogram (eeg); recording in coma or sleep only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0455","name":"Pump uninterrupted infusion","description":"Infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol)","date_of_service":"2026-05-10","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":"92353","name":"Fit aphakia spectcl multifoc","description":"Fitting of spectacle prosthesis for aphakia; multifocal","date_of_service":"2026-05-10","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":"31605","name":"Emer tracheostomy cthyr mem","description":"Tracheostomy, emergency procedure; cricothyroid membrane","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91200","name":"Liver elastography","description":"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78130","name":"Red cell survival study","description":"Red cell survival study","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95867","name":"Ndl emg cranial nrv musc uni","description":"Needle electromyography; cranial nerve supplied muscle(s), unilateral","date_of_service":"2026-05-10","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":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4420","name":"Ost pch clsd for bar w lk fl","description":"Ostomy pouch, closed; for use on barrier with locking flange (2 piece), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"31780","name":"Reconstruct windpipe","description":"Excision tracheal stenosis and anastomosis; cervical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"26550","name":"Pollicization digit","description":"Pollicization of a digit","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00454","name":"Anes px clav&scapula bx clav","description":"Anesthesia for procedures on clavicle and scapula; biopsy of clavicle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"90748","name":"Hib-hepb vaccine im","description":"Hepatitis b and haemophilus influenzae type b vaccine (hib-hepb), for intramuscular use","date_of_service":"2026-05-10","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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2159.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"01650","name":"Anes art sho&ax nos","description":"Anesthesia for procedures on arteries of shoulder and axilla; not otherwise specified","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0710","name":"Ctlso a-p-l control w/ inter","description":"Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"50045","name":"Nephrotomy w/exploration","description":"Nephrotomy, with exploration","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1021.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"46257","name":"Remove in/ex hem grp & fiss","description":"Hemorrhoidectomy, internal and external, single column/group; with fissurectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78232","name":"Salivary gland function std","description":"Salivary gland function study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["AU","AV"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5617","name":"Ak/bk self-aligning unit ea","description":"Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"83912","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"92140","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25370","name":"Revise radius or ulna","description":"Multiple osteotomies, with realignment on intramedullary rod (sofield type procedure); radius or ulna","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1460.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"36200","name":"Place catheter in aorta","description":"Introduction of catheter, aorta","date_of_service":"2026-05-10","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":"88141","name":"Cytopath c/v interpret","description":"Cytopathology, cervical or vaginal (any reporting system), requiring interpretation by physician","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86161","name":"Complement/function activity","description":"Complement; functional activity, each component","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1482.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5210","name":"No knee/ankle joints w/ ft b","description":"Above knee, short prosthesis, no knee joint (stubbies), with foot blocks, no ankle joints, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"28220","name":"Release of foot tendon","description":"Tenolysis, flexor, foot; single tendon","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43825","name":"Gastrojejunostomy w/vagotomy","description":"Gastrojejunostomy; with vagotomy, any type","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"P9048","name":"Plasmaprotein fract,5%,250ml","description":"Infusion, plasma protein fraction (human), 5%, 250 ml","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49060","name":"Drain open retroperi abscess","description":"Drainage of retroperitoneal abscess, open","date_of_service":"2026-05-10","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":"78110","name":"Plasma volume single","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling","date_of_service":"2026-05-10","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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-10","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":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"57107","name":"Vagnc compl rmvl paravag tis","description":"Vaginectomy, partial removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78202","name":"Liver imaging with vasc flow","description":"Liver imaging; with vascular flow","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27792","name":"Treatment of ankle fracture","description":"Open treatment of distal fibular fracture (lateral malleolus), includes internal fixation, when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44900","name":"I&d appendix abscess open","description":"Incision and drainage of appendiceal abscess, open","date_of_service":"2026-05-10","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":"87582","name":"M.pneumon dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); mycoplasma pneumoniae, quantification","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"90824","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57307","name":"Fistula repair & colostomy","description":"Closure of rectovaginal fistula; abdominal approach, with concomitant colostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83051","name":"Hemoglobin plasma","description":"Hemoglobin; plasma","date_of_service":"2026-05-10","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":"G0356","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1165.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2755","name":"Uv lens/es","description":"U-v lens, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"L4350","name":"Ankle control ortho pre ots","description":"Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"20206","name":"Biopsy muscle perq needle","description":"Biopsy, muscle, percutaneous needle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"83030","name":"Hemoglobin f fetal chemical","description":"Hemoglobin; f (fetal), chemical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L8625","name":"Charger coch impl/aoi battry","description":"External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"J8530","name":"Cyclophosphamide oral 25 mg","description":"Cyclophosphamide; oral, 25 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53215","name":"Removal of urethra","description":"Urethrectomy, total, including cystostomy; male","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35695","name":"Art trnsposj carotid subclav","description":"Transposition and/or reimplantation; carotid to subclavian artery","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3353.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1588.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4415","name":"Ost skn barr w/o conv >4 sqi","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-10","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":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76819","name":"Fetal biophys profil w/o nst","description":"Fetal biophysical profile; without non-stress testing","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"37615","name":"Ligation major artery neck","description":"Ligation, major artery (eg, post-traumatic, rupture); neck","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54430","name":"Revision of penis","description":"Corpora cavernosa-corpus spongiosum shunt (priapism operation), unilateral or bilateral","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6935","name":"Below elbow myoelectronic ct","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":634.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01922","name":"Anes n-invas img/radj ther","description":"Anesthesia for non-invasive imaging or radiation therapy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"85170","name":"Blood clot retraction","description":"Clot retraction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"G0418","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96003","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","date_of_service":"2026-05-10","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":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31238","name":"Nsl/sins ndsc srg nsl hemrrg","description":"Nasal/sinus endoscopy, surgical; with control of nasal hemorrhage","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6580","name":"Wrist/elbow bowden cable mol","description":"Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-10","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":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","date_of_service":"2026-05-10","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":"78600","name":"Brain image < 4 views","description":"Brain imaging, less than 4 static views;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96520","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"20527","name":"Njx nzm palmar fascial cord","description":"Injection, enzyme (eg, collagenase), palmar fascial cord (ie, dupuytrens contracture)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27509","name":"Treatment of thigh fracture","description":"Percutaneous skeletal fixation of femoral fracture, distal end, medial or lateral condyle, or supracondylar or transcondylar, with or without intercondylar extension, or distal femoral epiphyseal separation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50620","name":"Removal of ureter stone","description":"Ureterolithotomy; middle one-third of ureter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21125","name":"Augmentation mndblr prostc","description":"Augmentation, mandibular body or angle; prosthetic material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86300","name":"Immunoassay tumor ca 15-3","description":"Immunoassay for tumor antigen, quantitative; ca 15-3 (27.29)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3290.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"83068","name":"Hemoglobin unstable screen","description":"Hemoglobin; unstable, screen","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":870.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-05-10","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":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KC"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42835","name":"Removal of adenoids","description":"Adenoidectomy, secondary; younger than age 12","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27604","name":"Drain lower leg bursa","description":"Incision and drainage, leg or ankle; infected bursa","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":415.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-10","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":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-10","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":"54235","name":"Njx corpora cavernosa rx agt","description":"Injection of corpora cavernosa with pharmacologic agent(s) (eg, papaverine, phentolamine)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1457","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72195","name":"Mri pelvis w/o dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s)","date_of_service":"2026-05-10","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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00534","name":"Anes insertion/rplcmt cvdfb","description":"Anesthesia for transvenous insertion or replacement of pacing cardioverter-defibrillator","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6675","name":"Harness figure of 8 sing con","description":"Upper extremity addition, harness, (e.g., figure of eight type), single cable design","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0606","name":"Drainage board postural","description":"Postural drainage board","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86904","name":"Blood typing patient serum","description":"Blood typing, serologic; antigen screening for compatible unit using patient serum, per unit screened","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52640","name":"Relieve bladder contracture","description":"Transurethral resection; of postoperative bladder neck contracture","date_of_service":"2026-05-10","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":"54385","name":"Repair penis","description":"Plastic operation on penis for epispadias distal to external sphincter; with incontinence","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"A4373","name":"Skin barrier with flange","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each","date_of_service":"2026-05-10","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":"49905","name":"Omental flap intra-abdom","description":"Omental flap, intra-abdominal (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"43331","name":"Esophagomyotomy thoracic","description":"Esophagomyotomy (heller type); thoracic approach","date_of_service":"2026-05-10","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":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33503","name":"Coronary artery graft","description":"Repair of anomalous coronary artery from pulmonary artery origin; by graft, without cardiopulmonary bypass","date_of_service":"2026-05-10","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":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27134","name":"Revise hip joint replacement","description":"Revision of total hip arthroplasty; both components, with or without autograft or allograft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28030","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43327","name":"Esoph fundoplasty lap","description":"Esophagogastric fundoplasty partial or complete; laparotomy","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"35820","name":"Explore chest vessels","description":"Exploration for postoperative hemorrhage, thrombosis or infection; chest","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1749.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72072","name":"X-ray exam thorac spine 3vws","description":"Radiologic examination, spine; thoracic, 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0373","name":"Nonpowered pressure mattress","description":"Nonpowered advanced pressure reducing mattress","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"47371","name":"Laparo ablate liver cryosurg","description":"Laparoscopy, surgical, ablation of 1 or more liver tumor(s); cryosurgical","date_of_service":"2026-05-10","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":"G9678","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J0585","name":"Injection,onabotulinumtoxina","description":"Injection, onabotulinumtoxina, 1 unit","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A6450","name":"Lt compres band >=5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2617","name":"Custom fab w/c back cushion","description":"Custom fabricated wheelchair back cushion, any size, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2794.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33977","name":"Remove ventricular device","description":"Removal of ventricular assist device; extracorporeal, single ventricle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":980.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46910","name":"Destruction anal lesion(s)","description":"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; electrodesiccation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32851","name":"Lung transplant single","description":"Lung transplant, single; without cardiopulmonary bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3238.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2303","name":"Lens sphcy trifocal 4.0/.12-","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":812.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88240","name":"Cell cryopreserve/storage","description":"Cryopreservation, freezing and storage of cells, each cell line","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"55400","name":"Repair of sperm duct","description":"Vasovasostomy, vasovasorrhaphy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1902","name":"Afo ankle gauntlet pre ots","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32201","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86698","name":"Histoplasma antibody","description":"Antibody; histoplasma","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85002","name":"Bleeding time test","description":"Bleeding time","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"49040","name":"Drain open abdom abscess","description":"Drainage of subdiaphragmatic or subphrenic abscess, open","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":961.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"70373","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"88147","name":"Cytopath c/v automated","description":"Cytopathology smears, cervical or vaginal; screening by automated system under physician supervision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65275","name":"Repair of eye wound","description":"Repair of laceration; cornea, nonperforating, with or without removal foreign body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","date_of_service":"2026-05-10","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":"94400","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"73080","name":"X-ray exam of elbow","description":"Radiologic examination, elbow; complete, minimum of 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6451","name":"Mod compres band w>=3in<5in/yd","description":"Moderate compression bandage, elastic, knitted/woven, load resistance of 1.25 to 1.34 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-10","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":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KF"]}],"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":"2026-05-10","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":"E1172","name":"Wheelchair amputee detach ar","description":"Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest","date_of_service":"2026-05-10","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":"78220","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"55300","name":"Prepare sperm duct x-ray","description":"Vasotomy for vasograms, seminal vesiculograms, or epididymograms, unilateral or bilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"95858","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":566.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":711.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":955.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":658.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1780.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"33414","name":"Repair of aortic valve","description":"Repair of left ventricular outflow tract obstruction by patch enlargement of the outflow tract","date_of_service":"2026-05-10","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":"82664","name":"Electrophoretic test","description":"Electrophoretic technique, not elsewhere specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93317","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; image acquisition, interpretation and report only","date_of_service":"2026-05-10","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":"78586","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"38724","name":"Removal of lymph nodes neck","description":"Cervical lymphadenectomy (modified radical neck dissection)","date_of_service":"2026-05-10","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":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0198T","name":"Ocular blood flow measure","description":"Measurement of ocular blood flow by repetitive intraocular pressure sampling, with interpretation and report","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","date_of_service":"2026-05-10","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":"78630","name":"Cerebrospinal fluid scan","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-10","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":"86606","name":"Aspergillus antibody","description":"Antibody; aspergillus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"33361","name":"Replace aortic valve perq","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; percutaneous femoral artery approach","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6147.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"73552","name":"X-ray exam of femur 2/>","description":"Radiologic examination, femur; minimum 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50220","name":"Remove kidney open","description":"Nephrectomy, including partial ureterectomy, any open approach including rib resection;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33271","name":"Insj subq impltbl dfb elctrd","description":"Insertion of subcutaneous implantable defibrillator electrode","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78582","name":"Lung ventilat&perfus imaging","description":"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6236","name":"Hydrocolld drg > 48 in w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19105","name":"Cryosurg ablate fa each","description":"Ablation, cryosurgical, of fibroadenoma, including ultrasound guidance, each fibroadenoma","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"75968","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"35304","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; tibioperoneal trunk artery","date_of_service":"2026-05-10","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":"76775","name":"Us exam abdo back wall lim","description":"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0968","name":"Wheelchair commode seat","description":"Commode seat, wheelchair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"76873","name":"Echograp trans r pros study","description":"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1525.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00634","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"90694","name":"Vacc aiiv4 no prsrv 0.5ml im","description":"Influenza virus vaccine, quadrivalent (aiiv4), inactivated, adjuvanted, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","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":77.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82373","name":"Assay c-d transfer measure","description":"Carbohydrate deficient transferrin","date_of_service":"2026-05-10","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":"82725","name":"Assay of blood fatty acids","description":"Fatty acids, nonesterified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3929","name":"Hfo nontorsion jnts pre cst","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":828.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":763.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50605","name":"Insert ureteral support","description":"Ureterotomy for insertion of indwelling stent, all types","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1041.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"1111F","name":"Dschrg med/current med merge","description":"Discharge medications reconciled with the current medication list in outpatient medical record (coa) (ger)","date_of_service":"2026-05-10","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":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84580","name":"Assay of urine urobilinogen","description":"Urobilinogen, urine; quantitative, timed specimen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"26991","name":"Drainage of pelvis bursa","description":"Incision and drainage, pelvis or hip joint area; infected bursa","date_of_service":"2026-05-10","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":"65930","name":"Remove blood clot from eye","description":"Removal of blood clot, anterior segment of eye","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76800","name":"Us exam spinal canal","description":"Ultrasound, spinal canal and contents","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94726","name":"Plethysmography lung volumes","description":"Plethysmography for determination of lung volumes and, when performed, airway resistance","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"54230","name":"Njx corpora cavernosograpy","description":"Injection procedure for corpora cavernosography","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2537.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-10","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":"43850","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88386","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51840","name":"Attach bladder/urethra","description":"Anterior vesicourethropexy, or urethropexy (eg, marshall-marchetti-krantz, burch); simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":768.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KN"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0486","name":"Tlso rigidlined cust fab two","description":"Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlappin","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"27612","name":"Exploration of ankle joint","description":"Arthrotomy, posterior capsular release, ankle, with or without achilles tendon lengthening","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"78596","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"T5001","name":"Position seat spec orth need","description":"Positioning seat for persons with special orthopedic needs","date_of_service":"2026-05-10","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":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0260","name":"Hosp bed semi-electr w/ matt","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78704","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":788.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0572","name":"Aerosol compressor adjust pr","description":"Aerosol compressor, adjustable pressure, light duty for intermittent use","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":592.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0986","name":"Man w/c powr assist syst","description":"Manual wheelchair accessory, power assist system","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"G0375","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L0210","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"47500","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2330","name":"Lacer molded to patient mode","description":"Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2409.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"A6580","name":"Custom grad com glove heavy","description":"Gradient  compression glove, custom, heavy weight, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q9946","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"Q0497","name":"Bat clps elec/comb vad, rep","description":"Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","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":"95834","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21206","name":"Reconstruct upper jaw bone","description":"Osteotomy, maxilla, segmental (eg, wassmund or schuchard)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1260.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1428.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"21310","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"88289","name":"Chromosome study additional","description":"Chromosome analysis; additional high resolution study","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1724.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54300","name":"Revision of penis","description":"Plastic operation of penis for straightening of chordee (eg, hypospadias), with or without mobilization of urethra","date_of_service":"2026-05-10","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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27454","name":"Realignment of thigh bone","description":"Osteotomy, multiple, with realignment on intramedullary rod, femoral shaft (eg, sofield type procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0470","name":"Tlso rigid frame pre subclav","description":"Tlso, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction to scapula, lateral strength provided by pelvic, thoracic, and lateral frame pieces, rotational strength provided by subclavicular extensions, restr","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"43415","name":"Repair esophagus wound","description":"Suture of esophageal wound or injury; transthoracic or transabdominal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":922.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"78120","name":"Red cell mass single","description":"Red cell volume determination (separate procedure); single sampling","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":510.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76350","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1227","name":"Wheelchair spec sz spec ht a","description":"Special height arms for wheelchair","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1536.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","date_of_service":"2026-05-10","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":"88355","name":"M/phmtrc alys skeletal musc","description":"Morphometric analysis; skeletal muscle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":503.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"T4538","name":"Diaper serv reusable diaper","description":"Diaper service, reusable diaper, each diaper","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"J9178","name":"Inj, epirubicin hcl, 2 mg","description":"Injection, epirubicin hcl, 2 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76830","name":"Transvaginal us non-ob","description":"Ultrasound, transvaginal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1384.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"82003","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"70330","name":"X-ray exam of jaw joints","description":"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92614","name":"Laryngoscopic sensory vid","description":"Flexible endoscopic evaluation, laryngeal sensory testing by cine or video recording;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-05-10","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":"A4429","name":"Urine ost pouch w bltinconv","description":"Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-10","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":"E0249","name":"Pad water circulating heat u","description":"Pad for water circulating heat unit, for replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"84311","name":"Spectrophotometry","description":"Spectrophotometry, analyte not elsewhere specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":798.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77290","name":"Ther rad simulaj field cplx","description":"Therapeutic radiology simulation-aided field setting; complex","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"37229","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5661.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31512","name":"Removal of larynx lesion","description":"Laryngoscopy, indirect; with removal of lesion","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KM"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1124.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"01842","name":"Anes art farm wrst&hnd emblc","description":"Anesthesia for procedures on arteries of forearm, wrist, and hand; embolectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6238","name":"Hydrocolld drg >16<=48 w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1000.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"75992","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":786.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2676.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q2006","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"92545","name":"Oscillating tracking test","description":"Oscillating tracking test, with recording","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"0207T","name":"Clear eyelid gland w/heat","description":"Evacuation of meibomian glands, automated, using heat and intermittent pressure, unilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26510","name":"Thumb tendon transfer","description":"Cross intrinsic transfer, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74021","name":"Radex abdomen 3+ views","description":"Radiologic examination, abdomen; 3 or more views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99326","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27420","name":"Revision of unstable kneecap","description":"Reconstruction of dislocating patella; (eg, hauser type procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":626.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75962","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37209","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"92982","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6243","name":"Hydrogel drg >16<=48 w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"84681","name":"Assay of c-peptide","description":"C-peptide","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","date_of_service":"2026-05-10","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":"77605","name":"Hyperthermia ext gen deep","description":"Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KL","NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1721.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"67805","name":"Remove eyelid lesions","description":"Excision of chalazion; multiple, different lids","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73050","name":"X-ray exam of shoulders","description":"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21356","name":"Opn tx dprsd zygomatic arch","description":"Open treatment of depressed zygomatic arch fracture (eg, gillies approach)","date_of_service":"2026-05-10","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":"L3970","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28570","name":"Treat foot dislocation","description":"Closed treatment of talotarsal joint dislocation; without anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64646","name":"Chemodenerv trunk musc 1-5","description":"Chemodenervation of trunk muscle(s); 1-5 muscle(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29883","name":"Arthrs kne srg mnisc rpr m&l","description":"Arthroscopy, knee, surgical; with meniscus repair (medial and lateral)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1005.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","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":"23140","name":"Removal of bone lesion","description":"Excision or curettage of bone cyst or benign tumor of clavicle or scapula;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01212","name":"Anes open px hip jt disrtcj","description":"Anesthesia for open procedures involving hip joint; hip disarticulation","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6900","name":"Hand restorat thumb/1 finger","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82595","name":"Assay of cryoglobulin","description":"Cryoglobulin, qualitative or semi-quantitative (eg, cryocrit)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"26545","name":"Reconstruct finger joint","description":"Reconstruction, collateral ligament, interphalangeal joint, single, including graft, each joint","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1242.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"37609","name":"Ligation/bx temporal artery","description":"Ligation or biopsy, temporal artery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"53400","name":"Revise urethra stage 1","description":"Urethroplasty; first stage, for fistula, diverticulum, or stricture (eg, johannsen type)","date_of_service":"2026-05-10","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":"A6197","name":"Alginate drsg >16 <=48 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KM"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3931","name":"Whfo nontorsion joint prefab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":476.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83068","name":"Hemoglobin unstable screen","description":"Hemoglobin; unstable, screen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3976","name":"Sewhfo airplane w/o jnts cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"00176","name":"Anes intraoral px rad surg","description":"Anesthesia for intraoral procedures, including biopsy; radical surgery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42806","name":"Biopsy of upper nose/throat","description":"Biopsy; nasopharynx, survey for unknown primary lesion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54000","name":"Slitting of prepuce","description":"Slitting of prepuce, dorsal or lateral (separate procedure); newborn","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-10","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":"67041","name":"Vit for macular pucker","description":"Vitrectomy, mechanical, pars plana approach; with removal of preretinal cellular membrane (eg, macular pucker)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":689.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J9010","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77293","name":"Respirator motion mgmt simul","description":"Respiratory motion management simulation (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["26"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1000.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01340","name":"Anes clsd px lower 1/3 femur","description":"Anesthesia for all closed procedures on lower one-third of femur","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1308.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"G0368","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"53661","name":"Dilation of urethra","description":"Dilation of female urethra including suppository and/or instillation; subsequent","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"75968","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86486","name":"Skin test unlisted antign ea","description":"Skin test; unlisted antigen, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"35495","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1652","name":"Ho bi thighcuffs w sprdr bar","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86344","name":"Leukocyte phagocytosis","description":"Leukocyte phagocytosis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27566","name":"Treat kneecap dislocation","description":"Open treatment of patellar dislocation, with or without partial or total patellectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1079.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36460","name":"Intrauterine transfusion ftl","description":"Transfusion, intrauterine, fetal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7007","name":"Lg vol nebulizer disposable","description":"Large volume nebulizer, disposable, unfilled, used with aerosol compressor","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"90822","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41016","name":"Drainage of mouth lesion","description":"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; submental","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2205","name":"Lens sphcy bifocal 4.00d/4.2","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5220","name":"No knee joint with artic ali","description":"Above knee, short prosthesis, no knee joint (stubbies), with articulated ankle/foot, dynamically aligned, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82240","name":"Bile acids cholylglycine","description":"Bile acids; cholylglycine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2323.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"53215","name":"Removal of urethra","description":"Urethrectomy, total, including cystostomy; male","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24160","name":"Rmvl prosthhumrl&ulnar cmpnt","description":"Removal of prosthesis, includes debridement and synovectomy when performed; humeral and ulnar components","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1059.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89132","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5683","name":"Initial custom socket insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-05-10","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":"Q9953","name":"Inj fe-based mr contrast,1ml","description":"Injection, iron-based magnetic resonance contrast agent, per ml","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"01732","name":"Anes dx arthrs px elbow jt","description":"Anesthesia for diagnostic arthroscopic procedures of elbow joint","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"35452","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76393","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0174","name":"Cerv sr 2pc thor ext pre ots","description":"Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53449","name":"Repair uro sphincter","description":"Repair of inflatable urethral/bladder neck sphincter, including pump, reservoir, and cuff","date_of_service":"2026-05-10","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":"T4541","name":"Large disposable underpad","description":"Incontinence product, disposable underpad, large, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"53230","name":"Removal of urethra lesion","description":"Excision of urethral diverticulum (separate procedure); female","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6445","name":"Conform band s w <3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4414","name":"Ost sknbar w/o conv<=4 sq in","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","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":"83906","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27305","name":"Incise thigh tendon & fascia","description":"Fasciotomy, iliotibial (tenotomy), open","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"40654","name":"Rpr lip fth>1half ver ht/cpx","description":"Repair lip, full thickness; over one-half vertical height, or complex","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":490.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0720","name":"Ctlso a-p-l control custom","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2312","name":"Lens sphc trifo 7.25-12/2.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0745","name":"Neuromuscular stim for shock","description":"Neuromuscular stimulator, electronic shock unit","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","date_of_service":"2026-05-10","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":"27437","name":"Revise kneecap","description":"Arthroplasty, patella; without prosthesis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":786.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":859.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"70486","name":"Ct maxillofacial w/o dye","description":"Computed tomography, maxillofacial area; without contrast material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65760","name":"Keratomileusis","description":"Keratomileusis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86641","name":"Cryptococcus antibody","description":"Antibody; cryptococcus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"65400","name":"Removal of eye lesion","description":"Excision of lesion, cornea (keratectomy, lamellar, partial), except pterygium","date_of_service":"2026-05-10","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":"21084","name":"Impres&prep sp aid prosth","description":"Impression and custom preparation; speech aid prosthesis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"85049","name":"Automated platelet count","description":"Blood count; platelet, automated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21465","name":"Optx mndblr cndylr fx","description":"Open treatment of mandibular condylar fracture","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"43313","name":"Esophagoplasty congenital","description":"Esophagoplasty for congenital defect (plastic repair or reconstruction), thoracic approach; without repair of congenital tracheoesophageal fistula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3083.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0945","name":"Belt/harness extremity","description":"Extremity belt/harness","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1497.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1426.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27686","name":"Revise lower leg tendons","description":"Lengthening or shortening of tendon, leg or ankle; multiple tendons (through same incision), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35351","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; iliac","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1606.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1389.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86510","name":"Histoplasmosis skin test","description":"Skin test; histoplasmosis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"J2941","name":"Somatropin injection","description":"Injection, somatropin, 1 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75671","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":747.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6521","name":"G com garmnt glove nght cust","description":"Gradient compression garment, glove, padded, for nighttime use, custom, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58300","name":"Insert intrauterine device","description":"Insertion of intrauterine device (iud)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54308","name":"Reconstruction of urethra","description":"Urethroplasty for second stage hypospadias repair (including urinary diversion); less than 3 cm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82486","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33737","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"82715","name":"Assay of fecal fat","description":"Fat differential, feces, quantitative","date_of_service":"2026-05-10","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":"93880","name":"Extracranial bilat study","description":"Duplex scan of extracranial arteries; complete bilateral study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21083","name":"Impres&prep paltl lft prosth","description":"Impression and custom preparation; palatal lift prosthesis","date_of_service":"2026-05-10","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":"30120","name":"Revision of nose","description":"Excision or surgical planing of skin of nose for rhinophyma","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1685.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU","KF",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86317","name":"Immunoassay infectious agent","description":"Immunoassay for infectious agent antibody, quantitative, not otherwise specified","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35372","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; deep (profunda) femoral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26450","name":"Incision of palm tendon","description":"Tenotomy, flexor, palm, open, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93025","name":"Microvolt t-wave assess","description":"Microvolt t-wave alternans for assessment of ventricular arrhythmias","date_of_service":"2026-05-10","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":"33600","name":"Closure of valve","description":"Closure of atrioventricular valve (mitral or tricuspid) by suture or patch","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1490.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75956","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":784.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73060","name":"X-ray exam of humerus","description":"Radiologic examination; humerus, minimum of 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00910","name":"Anes transurethral px nos","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); not otherwise specified","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"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":"2026-05-10","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":"21480","name":"Cltx tmprmand dislc 1st/sbsq","description":"Closed treatment of temporomandibular dislocation; initial or subsequent","date_of_service":"2026-05-10","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":"78110","name":"Plasma volume single","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5630","name":"Syme typ expandabl wall sckt","description":"Addition to lower extremity, symes type, expandable wall socket","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1372","name":"Oxy suppl heater for nebuliz","description":"Immersion external heater for nebulizer","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8512","name":"Gel cap for trach voice pros","description":"Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":"76641","name":"Ultrasound breast complete","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["26"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1394.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"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":"77469","name":"Io radiation tx management","description":"Intraoperative radiation treatment management","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"83913","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"60300","name":"Aspir/inj thyroid cyst","description":"Aspiration and/or injection, thyroid cyst","date_of_service":"2026-05-10","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":"92546","name":"Sinusoidal rotational test","description":"Sinusoidal vertical axis rotational testing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31825","name":"Repair of windpipe defect","description":"Surgical closure tracheostomy or fistula; with plastic repair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-10","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":"20662","name":"Application halo pelvic","description":"Application of halo, including removal; pelvic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95937","name":"Neuromuscular junction test","description":"Neuromuscular junction testing (repetitive stimulation, paired stimuli), each nerve, any 1 method","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42860","name":"Excision of tonsil tags","description":"Excision of tonsil tags","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":"84478","name":"Assay of triglycerides","description":"Triglycerides","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78216","name":"Lvr&spleen img w/vasc flow","description":"Liver and spleen imaging; with vascular flow","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-10","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":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25392","name":"Shorten radius & ulna","description":"Osteoplasty, radius and ulna; shortening (excluding 64876)","date_of_service":"2026-05-10","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":"35551","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":"35190","name":"Repair acq av fistula xtr","description":"Repair, acquired or traumatic arteriovenous fistula; extremities","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":940.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3388.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"58674","name":"Laps abltj uterine fibroids","description":"Laparoscopy, surgical, ablation of uterine fibroid(s) including intraoperative ultrasound guidance and monitoring, radiofrequency","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":523.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78191","name":"Platelet survival study","description":"Platelet survival study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69820","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"00906","name":"Anes vulvectomy","description":"Anesthesia for; vulvectomy","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32605","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"86692","name":"Hepatitis delta agent antbdy","description":"Antibody; hepatitis, delta agent","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"94150","name":"Vital capacity test","description":"Vital capacity, total (separate procedure)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":856.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2080","name":"Hkafo unilat torsion cable","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46751","name":"Repair of anal sphincter","description":"Sphincteroplasty, anal, for incontinence or prolapse; child","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":675.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5671","name":"Bk/ak locking mechanism","description":"Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2632","name":"Post chmbr intraocular lens","description":"Posterior chamber intraocular lens","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","date_of_service":"2026-05-10","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":"Q4026","name":"Cast sup hip spica fiberglas","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4064.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27333","name":"Removal of knee cartilage","description":"Arthrotomy, with excision of semilunar cartilage (meniscectomy) knee; medial and lateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":698.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L7402","name":"Add ue prost s/d ultlite mat","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5648","name":"Above knee cushion socket","description":"Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-10","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":"93618","name":"Indctj arrhythmia elec pacg","description":"Induction of arrhythmia by electrical pacing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"73520","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21805","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67120","name":"Remove eye implant material","description":"Removal of implanted material, posterior segment; extraocular","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":561.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68801","name":"Dilate tear duct opening","description":"Dilation of lacrimal punctum, with or without irrigation","date_of_service":"2026-05-10","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":"74740","name":"X-ray female genital tract","description":"Hysterosalpingography, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"33235","name":"Removal pacemaker electrode","description":"Removal of transvenous pacemaker electrode(s); dual lead system","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-10","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":"52283","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with steroid injection into stricture","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"46261","name":"Remove in/ex hem grps & fiss","description":"Hemorrhoidectomy, internal and external, 2 or more columns/groups; with fissurectomy","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"46947","name":"Hemorrhoidopexy by stapling","description":"Hemorrhoidopexy (eg, for prolapsing internal hemorrhoids) by stapling","date_of_service":"2026-05-10","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":"50543","name":"Laparo partial nephrectomy","description":"Laparoscopy, surgical; partial nephrectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19361","name":"Brst rcnstj latsms drsi flap","description":"Breast reconstruction; with latissimus dorsi flap","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1562.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":695.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1686","name":"Ho post-op hip abduction","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2107.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21199","name":"Reconstr lwr jaw w/advance","description":"Osteotomy, mandible, segmental; with genioglossus advancement","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":828.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6012","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"46500","name":"Injection into hemorrhoid(s)","description":"Injection of sclerosing solution, hemorrhoids","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2273.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6025","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21263","name":"Revise eye sockets","description":"Periorbital osteotomies for orbital hypertelorism, with bone grafts; with forehead advancement","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84238","name":"Assay nonendocrine receptor","description":"Receptor assay; non-endocrine (specify receptor)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78468","name":"Heart infarct image (ef)","description":"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37500","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":873.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":726.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0749","name":"Elec osteogen stim implanted","description":"Osteogenesis stimulator, electrical, surgically implanted","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":788.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"75736","name":"Artery x-rays pelvis","description":"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35583","name":"Vein byp grft fem-popliteal","description":"In-situ vein bypass; femoral-popliteal","date_of_service":"2026-05-10","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":"88362","name":"Nerve teasing preparations","description":"Nerve teasing preparations","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61630","name":"Balo angioplasty icr perq","description":"Balloon angioplasty, intracranial (eg, atherosclerotic stenosis), percutaneous","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1205.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00640","name":"Anes spine manipulation","description":"Anesthesia for manipulation of the spine or for closed procedures on the cervical, thoracic or lumbar spine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38770","name":"Remove pelvis lymph nodes","description":"Pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"0146T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"27050","name":"Biopsy of sacroiliac joint","description":"Arthrotomy, with biopsy; sacroiliac joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2160.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KM","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1830","name":"Adjust toe ext & flex device","description":"Dynamic adjustable toe extension and flexion device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24410","name":"Mlt osteot rlgnm imed rd hum","description":"Multiple osteotomies with realignment on intramedullary rod, humeral shaft (sofield type procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"48152","name":"Pancreatectomy","description":"Pancreatectomy, proximal subtotal with total duodenectomy, partial gastrectomy, choledochoenterostomy and gastrojejunostomy (whipple-type procedure); without pancreatojejunostomy","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","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":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-10","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":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1867.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6447","name":"Conform band s w >=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":931.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1568.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":674.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65270","name":"Repair of eye wound","description":"Repair of laceration; conjunctiva, with or without nonperforating laceration sclera, direct closure","date_of_service":"2026-05-10","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":"23330","name":"Remove shoulder foreign body","description":"Removal of foreign body, shoulder; subcutaneous","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-10","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":"90371","name":"Hep b ig im","description":"Hepatitis b immune globulin (hbig), human, for intramuscular use","date_of_service":"2026-05-10","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":140.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85302","name":"Clot inhibit prot c antigen","description":"Clotting inhibitors or anticoagulants; protein c, antigen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85370","name":"Fibrinogen test","description":"Fibrin(ogen) degradation (split) products (fdp) (fsp); quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87184","name":"Sc std disk method per plate","description":"Susceptibility studies, antimicrobial agent; disk method, per plate (12 or fewer agents)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L2330","name":"Lacer molded to patient mode","description":"Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only","date_of_service":"2026-05-10","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":"52283","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with steroid injection into stricture","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20827","name":"Replantation thumb complete","description":"Replantation, thumb (includes distal tip to mp joint), complete amputation","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51045","name":"Incise bladder/drain ureter","description":"Cystotomy, with insertion of ureteral catheter or stent (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4382.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92576","name":"Synthetic sentence id test","description":"Synthetic sentence identification test","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2527.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62194","name":"Replace/irrigate catheter","description":"Replacement or irrigation, subarachnoid/subdural catheter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0239","name":"Hydrocollator unit portable","description":"Hydrocollator unit, portable","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["26"]}],"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":"2026-05-10","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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":"00126","name":"Anes px ear tympanotomy","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; tympanotomy","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69801","name":"Incise inner ear","description":"Labyrinthotomy, with perfusion of vestibuloactive drug(s), transcanal","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32661","name":"Thoracoscopy w/pericard exc","description":"Thoracoscopy, surgical; with excision of pericardial cyst, tumor, or mass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"44120","name":"Removal of small intestine","description":"Enterectomy, resection of small intestine; single resection and anastomosis","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1035.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":771.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":474.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"47620","name":"Removal of gallbladder","description":"Cholecystectomy with exploration of common duct; with transduodenal sphincterotomy or sphincteroplasty, with or without cholangiography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1418.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83906","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"00868","name":"Anes xtrprtl px rnl transpl","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; renal transplant (recipient)","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00851","name":"Anes iper px tubal ligation","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; tubal ligation/transection","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77386","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92577","name":"Stenger test speech","description":"Stenger test, speech","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2013.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64605","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6575","name":"Gradient comp sleev/glov","description":"Gradient  compression arm sleeve and glove combination, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"73000","name":"X-ray exam of collar bone","description":"Radiologic examination; clavicle, complete","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1529.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93742","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"43760","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":922.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":815.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2330","name":"Lacer molded to patient mode","description":"Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"43239","name":"Egd biopsy single/multiple","description":"Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82055","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"90685","name":"Iiv4 vacc no prsv 0.25 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"33935","name":"Transplantation heart/lung","description":"Heart-lung transplant with recipient cardiectomy-pneumonectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4431.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1920","name":"Afo sing upright w/ adjust s","description":"Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33016","name":"Pericardiocentesis w/imaging","description":"Pericardiocentesis, including imaging guidance, when performed","date_of_service":"2026-05-10","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":"40525","name":"Reconstruct lip with flap","description":"Excision of lip; full thickness, reconstruction with local flap (eg, estlander or fan)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"48152","name":"Pancreatectomy","description":"Pancreatectomy, proximal subtotal with total duodenectomy, partial gastrectomy, choledochoenterostomy and gastrojejunostomy (whipple-type procedure); without pancreatojejunostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"ATP05","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"75807","name":"Lymph vessel x-ray trunk","description":"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46020","name":"Placement of seton","description":"Placement of seton","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26449","name":"Release forearm/hand tendon","description":"Tenolysis, complex, extensor tendon, finger, including forearm, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"97113","name":"Aquatic therapy/exercises","description":"Therapeutic procedure, 1 or more areas, each 15 minutes; aquatic therapy with therapeutic exercises","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1821","name":"Replacement interface spsd","description":"Replacement soft interface material/cuffs for bi-directional static progressive stretch device","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95824","name":"Eeg cerebral death only","description":"Electroencephalogram (eeg); cerebral death evaluation only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70140","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; less than 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"82759","name":"Assay of rbc galactokinase","description":"Galactokinase, rbc","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1053.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52351","name":"Cystouretero & or pyeloscope","description":"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; diagnostic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1599.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","date_of_service":"2026-05-10","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":"43313","name":"Esophagoplasty congenital","description":"Esophagoplasty for congenital defect (plastic repair or reconstruction), thoracic approach; without repair of congenital tracheoesophageal fistula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2265.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92546","name":"Sinusoidal rotational test","description":"Sinusoidal vertical axis rotational testing","date_of_service":"2026-05-10","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":"E0947","name":"Fracture frame attachmnts pe","description":"Fracture frame, attachments for complex pelvic traction","date_of_service":"2026-05-10","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":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","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":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1303.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"26568","name":"Lengthen metacarpal/finger","description":"Osteoplasty, lengthening, metacarpal or phalanx","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1087","name":"Wheelchair lightwt fixed arm","description":"High strength lightweight wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34812","name":"Opn fem art expos","description":"Open femoral artery exposure for delivery of endovascular prosthesis, by groin incision, unilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L6580","name":"Wrist/elbow bowden cable mol","description":"Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"78102","name":"Bone marrow imaging ltd","description":"Bone marrow imaging; limited area","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"C1879","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"61567","name":"Incision of brain tissue","description":"Craniotomy with elevation of bone flap; for multiple subpial transections, with electrocorticography during surgery","date_of_service":"2026-05-10","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":"82375","name":"Assay carboxyhb quant","description":"Carboxyhemoglobin; quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15401","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77605","name":"Hyperthermia ext gen deep","description":"Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 cm)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"31368","name":"Partial removal of larynx","description":"Laryngectomy; subtotal supraglottic, with radical neck dissection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2460.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"69650","name":"Stapes mobilization","description":"Stapes mobilization","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1388.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"22520","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":698.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1440.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99174","name":"Ocular instrumnt screen bil","description":"Instrument-based ocular screening (eg, photoscreening, automated-refraction), bilateral; with remote analysis and report","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"27097","name":"Revision of hip tendon","description":"Release or recession, hamstring, proximal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":765.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":680.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"E1224","name":"Wheelchair spec size w/ leg","description":"Wheelchair with detachable arms, elevating legrests","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"38564","name":"Removal abdomen lymph nodes","description":"Limited lymphadenectomy for staging (separate procedure); retroperitoneal (aortic and/or splenic)","date_of_service":"2026-05-10","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":"56740","name":"Exc bartholins gland/cyst","description":"Excision of bartholins gland or cyst","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1436.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64475","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":583.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0467","name":"Home vent multi-function","description":"Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2411.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5512","name":"Multi den insert direct form","description":"For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patients foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"A6594","name":"G comp bandge liner lwr extr","description":"Gradient compression bandaging supply, bandage liner, lower extremity, any size or length, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28192","name":"Removal of foot foreign body","description":"Removal of foreign body, foot; deep","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"88347","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"83605","name":"Assay of lactic acid","description":"Lactate (lactic acid)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6403","name":"Sterile gauze>16 <= 48 sq in","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5055","name":"Stoma cap","description":"Stoma cap","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"72129","name":"Ct chest spine w/dye","description":"Computed tomography, thoracic spine; with contrast material","date_of_service":"2026-05-10","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":"95180","name":"Rapid desensitization","description":"Rapid desensitization procedure, each hour (eg, insulin, penicillin, equine serum)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0840","name":"Tract frame attach headboard","description":"Traction frame, attached to headboard, cervical traction","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"15361","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1834.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"23334","name":"Shoulder prosthesis removal","description":"Removal of prosthesis, includes debridement and synovectomy when performed; humeral or glenoid component","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49550","name":"Rpr rem hernia init reduce","description":"Repair initial femoral hernia, any age; reducible","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":620.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5611","name":"Ak 4 bar link w/fric swing","description":"Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":663.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"63704","name":"Repair of spinal herniation","description":"Repair of myelomeningocele; less than 5 cm diameter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0171","name":"Commode chair non-electric","description":"Commode chair with integrated seat lift mechanism, non-electric, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84300","name":"Assay of urine sodium","description":"Sodium; urine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76101","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"30200","name":"Injection treatment of nose","description":"Injection into turbinate(s), therapeutic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62361","name":"Implant spine infusion pump","description":"Implantation or replacement of device for intrathecal or epidural drug infusion; nonprogrammable pump","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77290","name":"Ther rad simulaj field cplx","description":"Therapeutic radiology simulation-aided field setting; complex","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26508","name":"Release thumb contracture","description":"Release of thenar muscle(s) (eg, thumb contracture)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":866.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1383.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1618.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":490.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29830","name":"Elbow arthroscopy","description":"Arthroscopy, elbow, diagnostic, with or without synovial biopsy (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A5500","name":"Diab shoe for density insert","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2665.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26180","name":"Removal of finger tendon","description":"Excision of tendon, finger, flexor or extensor, each tendon","date_of_service":"2026-05-10","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":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"A4606","name":"Oxygen probe used w oximeter","description":"Oxygen probe for use with oximeter device, replacement","date_of_service":"2026-05-10","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":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2101","name":"Single visn sphere 4.12-7.00","description":"Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"E0464","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"L2624","name":"Hip adj flex ext abduct cont","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50547","name":"Laparo removal donor kidney","description":"Laparoscopy, surgical; donor nephrectomy (including cold preservation), from living donor","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"76830","name":"Transvaginal us non-ob","description":"Ultrasound, transvaginal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-10","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":"E0481","name":"Intrpulmnry percuss vent sys","description":"Intrapulmonary percussive ventilation system and related accessories","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2508.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00846","name":"Anes iper px rad hystrectomy","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; radical hysterectomy","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5925","name":"Above knee manual lock","description":"Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","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":"29846","name":"Wrist arthroscopy/surgery","description":"Arthroscopy, wrist, surgical; excision and/or repair of triangular fibrocartilage and/or joint debridement","date_of_service":"2026-05-10","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":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"A7017","name":"Nebulizer not used w oxygen","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00730","name":"Anes px upper pst abdl wall","description":"Anesthesia for procedures on upper posterior abdominal wall","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"73550","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2533.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67901","name":"Repair eyelid defect","description":"Repair of blepharoptosis; frontalis muscle technique with suture or other material (eg, banked fascia)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78660","name":"Nuclear exam of tear flow","description":"Radiopharmaceutical dacryocystography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92586","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44136","name":"Intestine transplant live","description":"Intestinal allotransplantation; from living donor","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"44316","name":"Devise bowel pouch","description":"Continent ileostomy (kock procedure) (separate procedure)","date_of_service":"2026-05-10","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":"38221","name":"Dx bone marrow biopsies","description":"Diagnostic bone marrow; biopsy(ies)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28615","name":"Repair foot dislocation","description":"Open treatment of tarsometatarsal joint dislocation, includes internal fixation, when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84560","name":"Assay of urine/uric acid","description":"Uric acid; other source","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1989.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77310","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23190","name":"Ostectomy scapula partial","description":"Ostectomy of scapula, partial (eg, superior medial angle)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0010","name":"Stnd wt frame power whlchr","description":"Standard - weight frame motorized/power wheelchair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"S8428","name":"Ready gradient gauntlet","description":"Gradient pressure aid (gauntlet), ready made","date_of_service":"2026-05-10","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":"00350","name":"Anes px major vsl neck nos","description":"Anesthesia for procedures on major vessels of neck; not otherwise specified","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"86343","name":"Leukocyte histamine release","description":"Leukocyte histamine release test (lhr)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93533","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"78305","name":"Bone imaging multiple areas","description":"Bone and/or joint imaging; multiple areas","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"76101","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"57106","name":"Vagnc prtl rmvl vag wall","description":"Vaginectomy, partial removal of vaginal wall;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2771.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20553","name":"Njx 1/mlt trigger points 3/>","description":"Injection(s); single or multiple trigger point(s), 3 or more muscles","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-10","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":"92611","name":"Motion fluoroscopy/swallow","description":"Motion fluoroscopic evaluation of swallowing function by cine or video recording","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"73650","name":"X-ray exam of heel","description":"Radiologic examination; calcaneus, minimum of 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"84203","name":"Test rbc protoporphyrin","description":"Protoporphyrin, rbc; screen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"35556","name":"Art byp grft fem-popliteal","description":"Bypass graft, with vein; femoral-popliteal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1544.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"78012","name":"Thyroid uptake measurement","description":"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88356","name":"Analysis nerve","description":"Morphometric analysis; nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2690","name":"Procainamide hcl injection","description":"Injection, procainamide hcl, up to 1 gm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"26034","name":"Treat hand bone lesion","description":"Incision, bone cortex, hand or finger (eg, osteomyelitis or bone abscess)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":620.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":897.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82040","name":"Assay of serum albumin","description":"Albumin; serum, plasma or whole blood","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73660","name":"X-ray exam of toe(s)","description":"Radiologic examination; toe(s), minimum of 2 views","date_of_service":"2026-05-10","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":"L2415","name":"Knee joint cam lock each joi","description":"Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint","date_of_service":"2026-05-10","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":"92569","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"91052","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"81286","name":"Fxn gene full gene sequence","description":"Fxn (frataxin) (eg, friedreich ataxia) gene analysis; full gene sequence","date_of_service":"2026-05-10","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":"86777","name":"Toxoplasma antibody","description":"Antibody; toxoplasma","date_of_service":"2026-05-10","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":"26025","name":"Drainage of palm bursa","description":"Drainage of palmar bursa; single, bursa","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86860","name":"Rbc antibody elution","description":"Antibody elution (rbc), each elution","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"96373","name":"Ther/proph/diag inj ia","description":"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); intra-arterial","date_of_service":"2026-05-10","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":"E0935","name":"Cont pas motion exercise dev","description":"Continuous passive motion exercise device for use on knee only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-10","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":"01210","name":"Anes open px hip joint nos","description":"Anesthesia for open procedures involving hip joint; not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"24498","name":"Proph tx w/wo mthylmthcrylt","description":"Prophylactic treatment (nailing, pinning, plating or wiring), with or without methylmethacrylate, humeral shaft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1058.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1155.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70551","name":"Mri brain stem w/o dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"42507","name":"Parotid duct diversion","description":"Parotid duct diversion, bilateral (wilke type procedure);","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0194","name":"Air fluidized bed","description":"Air fluidized bed","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42665","name":"Ligation of salivary duct","description":"Ligation salivary duct, intraoral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"48120","name":"Removal of pancreas lesion","description":"Excision of lesion of pancreas (eg, cyst, adenoma)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1103.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34803","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"45341","name":"Sigmoidoscopy w/ultrasound","description":"Sigmoidoscopy, flexible; with endoscopic ultrasound examination","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"82975","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","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":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64508","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74010","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93875","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"69604","name":"Revj mstdc rsltg tympanplsty","description":"Revision mastoidectomy; resulting in tympanoplasty","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1294.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"J7050","name":"Normal saline solution infus","description":"Infusion, normal saline solution, 250 cc","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0210","name":"Methyldopate hcl injection","description":"Injection, methyldopate hcl, up to 250 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4500","name":"Below knee surgical stocking","description":"Surgical stockings below knee length, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28043","name":"Exc foot/toe tum sc < 1.5 cm","description":"Excision, tumor, soft tissue of foot or toe, subcutaneous; less than 1.5 cm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46945","name":"Int hrhc lig 1 hroid w/o img","description":"Hemorrhoidectomy, internal, by ligation other than rubber band; single hemorrhoid column/group, without imaging guidance","date_of_service":"2026-05-10","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":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-10","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":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","date_of_service":"2026-05-10","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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2631","name":"Iris support intraoclr lens","description":"Iris supported intraocular lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1629.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1071.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU","","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38500","name":"Biopsy/removal lymph nodes","description":"Biopsy or excision of lymph node(s); open, superficial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KF"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2157.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87015","name":"Specimen infect agnt concntj","description":"Concentration (any type), for infectious agents","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70110","name":"X-ray exam of jaw 4/> views","description":"Radiologic examination, mandible; complete, minimum of 4 views","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24577","name":"Cltx humrl cndylr fx w/mnpj","description":"Closed treatment of humeral condylar fracture, medial or lateral; with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":423.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30540","name":"Rpr choanal atresia ntranasl","description":"Repair choanal atresia; intranasal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1376.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15933","name":"Exc sac pr ulc prim str ostc","description":"Excision, sacral pressure ulcer, with primary suture; with ostectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"58562","name":"Hysteroscopy remove fb","description":"Hysteroscopy, surgical; with removal of impacted foreign body","date_of_service":"2026-05-10","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":"27715","name":"Ostpl tibfib lngth/shrt","description":"Osteoplasty, tibia and fibula, lengthening or shortening","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1259.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":846.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"35642","name":"Bpg carotid-vertebral","description":"Bypass graft, with other than vein; carotid-vertebral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"52260","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with dilation of bladder for interstitial cystitis; general or conduction (spinal) anesthesia","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","date_of_service":"2026-05-10","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":"47362","name":"Repair liver wound","description":"Management of liver hemorrhage; re-exploration of hepatic wound for removal of packing","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3775.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83615","name":"Lactate (ld) (ldh) enzyme","description":"Lactate dehydrogenase (ld), (ldh);","date_of_service":"2026-05-10","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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"92511","name":"Nasopharyngoscopy","description":"Nasopharyngoscopy with endoscope (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5682","name":"Bk thigh lacer glut/ischia m","description":"Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74250","name":"X-ray xm sm int 1cntrst std","description":"Radiologic examination, small intestine, including multiple serial images and scout abdominal radiograph(s), when performed; single-contrast (eg, barium) study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"97001","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"78232","name":"Salivary gland function std","description":"Salivary gland function study","date_of_service":"2026-05-10","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":"85293","name":"Clot factor wght kininogen","description":"Clotting; high molecular weight kininogen assay (fitzgerald factor assay)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"42953","name":"Repair throat esophagus","description":"Pharyngoesophageal repair","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"43810","name":"Gastroduodenostomy","description":"Gastroduodenostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"31505","name":"Diagnostic laryngoscopy","description":"Laryngoscopy, indirect; diagnostic (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6446","name":"Conform band s w>=3in <5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74470","name":"X-ray exam of kidney lesion","description":"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33417","name":"Repair of aortic valve","description":"Aortoplasty (gusset) for supravalvular stenosis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0290","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69666","name":"Repair middle ear structures","description":"Repair oval window fistula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":923.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1321.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84156","name":"Assay of protein urine","description":"Protein, total, except by refractometry; urine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"43351","name":"Surgical opening esophagus","description":"Esophagostomy, fistulization of esophagus, external; thoracic approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76932","name":"Echo guide for heart biopsy","description":"Ultrasonic guidance for endomyocardial biopsy, imaging supervision and interpretation","date_of_service":"2026-05-10","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":"G0009","name":"Admin pneumococcal vaccine","description":"Administration of pneumococcal vaccine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L5814","name":"Endo knee-shin hydral swg ph","description":"Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-10","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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":"77327","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68115","name":"Exc les conjunctiva >1 cm","description":"Excision of lesion, conjunctiva; over 1 cm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86021","name":"Wbc antibody identification","description":"Antibody identification; leukocyte antibodies","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1281.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2020","name":"Kafo dbl solid stirrup band/","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar ak orthosis), custom fabricated","date_of_service":"2026-05-10","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":"85292","name":"Clot factor fletcher fact","description":"Clotting; prekallikrein assay (fletcher factor assay)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"42810","name":"Excision of neck cyst","description":"Excision branchial cleft cyst or vestige, confined to skin and subcutaneous tissues","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64840","name":"Repair of leg nerve","description":"Suture of posterior tibial nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"83775","name":"Assay malate dehydrogenase","description":"Malate dehydrogenase","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"80160","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"52290","name":"Cystoscopy and treatment","description":"Cystourethroscopy; with ureteral meatotomy, unilateral or bilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78071","name":"Parathyrd planar w/wo subtrj","description":"Parathyroid planar imaging (including subtraction, when performed); with tomographic (spect)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"92511","name":"Nasopharyngoscopy","description":"Nasopharyngoscopy with endoscope (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":486.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7402","name":"Add ue prost s/d ultlite mat","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21086","name":"Impres&prep auricular prosth","description":"Impression and custom preparation; auricular prosthesis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1083.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57415","name":"Remove vaginal foreign body","description":"Removal of impacted vaginal foreign body (separate procedure) under anesthesia (other than local)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28615","name":"Repair foot dislocation","description":"Open treatment of tarsometatarsal joint dislocation, includes internal fixation, when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":784.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4542","name":"Supp ext up limb tremor stim","description":"Supplies and accessories for external upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27181","name":"Treat slipped epiphysis","description":"Open treatment of slipped femoral epiphysis; osteotomy and internal fixation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1183.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"44160","name":"Removal of colon","description":"Colectomy, partial, with removal of terminal ileum with ileocolostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1027.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64721","name":"Carpal tunnel surgery","description":"Neuroplasty and/or transposition; median nerve at carpal tunnel","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26554","name":"Double transfer toe-hand","description":"Transfer, toe-to-hand with microvascular anastomosis; other than great toe, double","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","date_of_service":"2026-05-10","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":"82656","name":"El-1 fecal qual/semiq","description":"Elastase, pancreatic (el-1), fecal; qualitative or semi-quantitative","date_of_service":"2026-05-10","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":"92020","name":"Gonioscopy","description":"Gonioscopy (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88738","name":"Hgb quant transcutaneous","description":"Hemoglobin (hgb), quantitative, transcutaneous","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"47300","name":"Surgery for liver lesion","description":"Marsupialization of cyst or abscess of liver","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1081.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58550","name":"Laparo-asst vag hysterectomy","description":"Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less;","date_of_service":"2026-05-10","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":"76355","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":809.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1971","name":"Afo w/ankle joint, prefab","description":"Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":669.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38300","name":"Drainage lymph node lesion","description":"Drainage of lymph node abscess or lymphadenitis; simple","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19302","name":"P-mastectomy w/ln removal","description":"Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy); with axillary lymphadenectomy","date_of_service":"2026-05-10","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":"J0885","name":"Epoetin alfa, non-esrd","description":"Injection, epoetin alfa, (for non-esrd use), 1000 units","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77326","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42120","name":"Remove palate/lesion","description":"Resection of palate or extensive resection of lesion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80157","name":"Assay carbamazepine free","description":"Carbamazepine; free","date_of_service":"2026-05-10","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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19082","name":"Bx breast add lesion strtctc","description":"Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; each additional lesion, including stereotactic guidance (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76003","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1808.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1268.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86376","name":"Microsomal antibody each","description":"Microsomal antibodies (eg, thyroid or liver-kidney), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"32420","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1597.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":840.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90805","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85303","name":"Clot inhibit prot c activity","description":"Clotting inhibitors or anticoagulants; protein c, activity","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"31292","name":"Nsl/sins ndsc med/inf dcmprn","description":"Nasal/sinus endoscopy, surgical, with orbital decompression; medial or inferior wall","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-10","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":"45379","name":"Colonoscopy w/fb removal","description":"Colonoscopy, flexible; with removal of foreign body(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1095.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86652","name":"Encephaltis east eqne anbdy","description":"Antibody; encephalitis, eastern equine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"V5364","name":"Dysphagia screening","description":"Dysphagia screening","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29886","name":"Arthrs knee surg drlg od les","description":"Arthroscopy, knee, surgical; drilling for intact osteochondritis dissecans lesion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","date_of_service":"2026-05-10","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":"47120","name":"Partial removal of liver","description":"Hepatectomy, resection of liver; partial lobectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"L3912","name":"Hfo flexion glove pre ots","description":"Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1656.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":364.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":904.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2006","name":"Kaf sng/dbl swg/stn mcpr cus","description":"Knee ankle foot device, any material, single or double upright, swing and stance phase microprocessor control with adjustability, includes all components (e.g., sensors, batteries, charger), any type activation, with or without ankle joint(s), custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57130","name":"Excision vaginal septum","description":"Excision of vaginal septum","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0976","name":"Lso full corset","description":"Lso, full corset","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"15845","name":"Skin and muscle repair face","description":"Graft for facial nerve paralysis; regional muscle transfer","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":985.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88388","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0010","name":"Stnd wt frame power whlchr","description":"Standard - weight frame motorized/power wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"J9200","name":"Floxuridine injection","description":"Injection, floxuridine, 500 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["KF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84235","name":"Assay of endocrine hormone","description":"Receptor assay; endocrine, other than estrogen or progesterone (specify hormone)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78018","name":"Thyroid met imaging body","description":"Thyroid carcinoma metastases imaging; whole body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":987.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50389","name":"Remove renal tube w/fluoro","description":"Removal of nephrostomy tube, requiring fluoroscopic guidance (eg, with concurrent indwelling ureteral stent)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79440","name":"Nuclear rx intra-articular","description":"Radiopharmaceutical therapy, by intra-articular administration","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4420","name":"Ost pch clsd for bar w lk fl","description":"Ostomy pouch, closed; for use on barrier with locking flange (2 piece), each","date_of_service":"2026-05-10","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":"85300","name":"Antithrombin iii activity","description":"Clotting inhibitors or anticoagulants; antithrombin iii, activity","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":725.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2208.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"32602","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"45563","name":"Exploration/repair of rectum","description":"Exploration, repair, and presacral drainage for rectal injury; with colostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1385.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72040","name":"X-ray exam neck spine 2-3 vw","description":"Radiologic examination, spine, cervical; 2 or 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"58559","name":"Hysteroscopy lysis","description":"Hysteroscopy, surgical; with lysis of intrauterine adhesions (any method)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3923","name":"Hfo without joints pre cst","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88300","name":"Surgical path gross","description":"Level i - surgical pathology, gross examination only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00567","name":"Anes direct cabg w/pump","description":"Anesthesia for direct coronary artery bypass grafting; with pump oxygenator","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61305","name":"Crnec/crnot expl infratntorl","description":"Craniectomy or craniotomy, exploratory; infratentorial (posterior fossa)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2192.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","date_of_service":"2026-05-10","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":"35860","name":"Explore limb vessels","description":"Exploration for postoperative hemorrhage, thrombosis or infection; extremity","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":733.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1162.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"61552","name":"Release of skull seams","description":"Craniectomy for craniosynostosis; multiple cranial sutures","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1293.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3977","name":"Sewhfo cap desgn w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"78071","name":"Parathyrd planar w/wo subtrj","description":"Parathyroid planar imaging (including subtraction, when performed); with tomographic (spect)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"92287","name":"Ant sgm img ir flrscn angrph","description":"Anterior segment imaging with interpretation and report; with fluorescein angiography","date_of_service":"2026-05-10","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":"73590","name":"X-ray exam of lower leg","description":"Radiologic examination; tibia and fibula, 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01965","name":"Anes incompl/missed ab px","description":"Anesthesia for incomplete or missed abortion procedures","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0880","name":"Trac stand free stand extrem","description":"Traction stand, free standing, extremity traction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"58823","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75952","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69405","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1025.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"L6695","name":"Elbow socket ins use w/o lck","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["TC"]}],"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":"2026-05-10","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":"85270","name":"Clot factor xi pta","description":"Clotting; factor xi (pta)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":512.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27475","name":"Surgery to stop leg growth","description":"Arrest, epiphyseal, any method (eg, epiphysiodesis); distal femur","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":784.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7502","name":"Cyclosporine oral 100 mg","description":"Cyclosporine, oral, 100 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93556","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3169.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"E1195","name":"Wheelchair amputee heavy dut","description":"Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"78305","name":"Bone imaging multiple areas","description":"Bone and/or joint imaging; multiple areas","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":291.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["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":"2026-05-10","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":"84479","name":"Assay of thyroid (t3 or t4)","description":"Thyroid hormone (t3 or t4) uptake or thyroid hormone binding ratio (thbr)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"47760","name":"Fuse bile ducts and bowel","description":"Anastomosis, of extrahepatic biliary ducts and gastrointestinal tract","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1784.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"G0502","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15920","name":"Exc coccygl pr ulc prim sutr","description":"Excision, coccygeal pressure ulcer, with coccygectomy; with primary suture","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64632","name":"N block inj common digit","description":"Destruction by neurolytic agent; plantar common digital nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33218","name":"Repair lead pace-defib one","description":"Repair of single transvenous electrode, permanent pacemaker or implantable defibrillator","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2257.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4409","name":"Ost skn barr convex <=4 sq i","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"L5656","name":"Socket insert knee articulat","description":"Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"30450","name":"Revision of nose","description":"Rhinoplasty, secondary; major revision (nasal tip work and osteotomies)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1928.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"82820","name":"Hemoglobin-oxygen affinity","description":"Hemoglobin-oxygen affinity (po2 for 50% hemoglobin saturation with oxygen)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"0295T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","date_of_service":"2026-05-10","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":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","date_of_service":"2026-05-10","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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6885","name":"Replc sockt shldr dis/interc","description":"Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-10","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":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":"21263","name":"Revise eye sockets","description":"Periorbital osteotomies for orbital hypertelorism, with bone grafts; with forehead advancement","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1904.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E2223","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"27429","name":"Reconstruction knee","description":"Ligamentous reconstruction (augmentation), knee; intra-articular (open) and extra-articular","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0984","name":"Add pwr tiller","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5681","name":"Intl custm cong/latyp insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43241","name":"Egd tube/cath insertion","description":"Esophagogastroduodenoscopy, flexible, transoral; with insertion of intraluminal tube or catheter","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"39530","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4714","name":"Treated water per gallon","description":"Treated water (deionized, distilled, or reverse osmosis) for peritoneal dialysis, per gallon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"70328","name":"X-ray exam of jaw joint","description":"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral","date_of_service":"2026-05-10","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":"43460","name":"Pressure treatment esophagus","description":"Esophagogastric tamponade, with balloon (sengstaken type)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6244","name":"Hydrogel drg >48 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78135","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94770","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"65220","name":"Remove foreign body from eye","description":"Removal of foreign body, external eye; corneal, without slit lamp","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70220","name":"X-ray exam of sinuses","description":"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53210","name":"Removal of urethra","description":"Urethrectomy, total, including cystostomy; female","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":846.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","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":"57155","name":"Insert uteri tandem/ovoids","description":"Insertion of uterine tandem and/or vaginal ovoids for clinical brachytherapy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6885","name":"Replc sockt shldr dis/interc","description":"Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"B4168","name":"Parenteral sol amino acid 3.","description":"Parenteral nutrition solution; amino acid, 3.5%, (500 ml = 1 unit) - home mix","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"74420","name":"Urography rtrgr +-kub","description":"Urography, retrograde, with or without kub","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11983","name":"Remove/insert drug implant","description":"Removal with reinsertion, non-biodegradable drug delivery implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"85597","name":"Phospholipid pltlt neutraliz","description":"Phospholipid neutralization; platelet","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"68326","name":"Revise/graft eyelid lining","description":"Conjunctivoplasty, reconstruction cul-de-sac; with conjunctival graft or extensive rearrangement","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":620.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57292","name":"Construct vagina with graft","description":"Construction of artificial vagina; with graft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":963.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76020","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83918","name":"Organic acids total quant","description":"Organic acids; total, quantitative, each specimen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35663","name":"Bpg ilioiliac","description":"Bypass graft, with other than vein; ilioiliac","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35870","name":"Repair vessel graft defect","description":"Repair of graft-enteric fistula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1555.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78016","name":"Thyroid met imaging/studies","description":"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0464","name":"Tlso 4mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, corona","date_of_service":"2026-05-10","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":"92567","name":"Tympanometry","description":"Tympanometry (impedance testing)","date_of_service":"2026-05-10","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":"50860","name":"Transplant ureter to skin","description":"Ureterostomy, transplantation of ureter to skin","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2704.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78160","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":428.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86732","name":"Mucormycosis antibody","description":"Antibody; mucormycosis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"11772","name":"Exc pilonidal cyst comp","description":"Excision of pilonidal cyst or sinus; complicated","date_of_service":"2026-05-10","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":"76529","name":"Echo exam of eye","description":"Ophthalmic ultrasonic foreign body localization","date_of_service":"2026-05-10","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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KF"]}],"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":"2026-05-10","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":"A6570","name":"Grad com garment genital","description":"Gradient compression garment, genital region, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"54400","name":"Insert semi-rigid prosthesis","description":"Insertion of penile prosthesis; non-inflatable (semi-rigid)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26320","name":"Removal of implant from hand","description":"Removal of implant from finger or hand","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00530","name":"Anes perm transvns pm insj","description":"Anesthesia for permanent transvenous pacemaker insertion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"00542","name":"Anes thrcm px decortication","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); decortication","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54650","name":"Orchiopexy (fowler-stephens)","description":"Orchiopexy, abdominal approach, for intra-abdominal testis (eg, fowler-stephens)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0601","name":"Repl batt silver oxide 1.5 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1331.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1512.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00522","name":"Anes clsd ch px ndl bx pleur","description":"Anesthesia for closed chest procedures; needle biopsy of pleura","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"25695","name":"Optx lunate dislocation","description":"Open treatment of lunate dislocation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47511","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57000","name":"Colpotomy w/exploration","description":"Colpotomy; with exploration","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2103","name":"Spherocylindr 4.00d/12-2.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2343","name":"W/c dpth 22-25 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"53853","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0113","name":"Pinworm examinations","description":"Pinworm examinations","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-10","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":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8002","name":"Brst prsth bra & bilat form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","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":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"73542","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"19350","name":"Nipple/areola reconstruction","description":"Nipple/areola reconstruction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71040","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1354.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31591","name":"Laryngoplasty medialization","description":"Laryngoplasty, medialization, unilateral","date_of_service":"2026-05-10","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":"87278","name":"Legion pneumophilia ag if","description":"Infectious agent antigen detection by immunofluorescent technique; legionella pneumophila","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"51702","name":"Insert temp bladder cath","description":"Insertion of temporary indwelling bladder catheter; simple (eg, foley)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76870","name":"Us exam scrotum","description":"Ultrasound, scrotum and contents","date_of_service":"2026-05-10","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":"23505","name":"Cltx clavicular fx w/mnpj","description":"Closed treatment of clavicular fracture; with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"L3570","name":"O shoe add instep extension","description":"Orthopedic shoe addition, special extension to instep (leather with eyelets)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"91000","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28288","name":"Partial removal of foot bone","description":"Ostectomy, partial, exostectomy or condylectomy, metatarsal head, each metatarsal head","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"14060","name":"Tis trnfr e/n/e/l 10 sq cm/<","description":"Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 10 sq cm or less","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"75831","name":"Vein x-ray kidney","description":"Venography, renal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77076","name":"Radex osseous survey infant","description":"Radiologic examination, osseous survey, infant","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1227","name":"Wheelchair spec sz spec ht a","description":"Special height arms for wheelchair","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0635","name":"Lso sagit rigid panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pr","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55520","name":"Removal of sperm cord lesion","description":"Excision of lesion of spermatic cord (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"25628","name":"Optx carpl scphd fx int fixj","description":"Open treatment of carpal scaphoid (navicular) fracture, includes internal fixation, when performed","date_of_service":"2026-05-10","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":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2525","name":"Th/wght bear nar m-l brim mo","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"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":"2026-05-10","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":"54385","name":"Repair penis","description":"Plastic operation on penis for epispadias distal to external sphincter; with incontinence","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1071.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"87283","name":"Rubeola ag if","description":"Infectious agent antigen detection by immunofluorescent technique; rubeola","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92544","name":"Optokinetic nystagmus test","description":"Optokinetic nystagmus test, bidirectional, foveal or peripheral stimulation, with recording","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q4075","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73010","name":"X-ray exam of shoulder blade","description":"Radiologic examination; scapula, complete","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-10","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":"B4185","name":"Pn soln nos 10 grams lipids","description":"Parenteral nutrition solution, not otherwise specified, 10 grams lipids","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"32601","name":"Thoracoscopy diagnostic","description":"Thoracoscopy, diagnostic (separate procedure); lungs, pericardial sac, mediastinal or pleural space, without biopsy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"35470","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"35560","name":"Art byp grft aortorenal","description":"Bypass graft, with vein; aortorenal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87550","name":"Mycobacteria dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria species, direct probe technique","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77011","name":"Ct scan for localization","description":"Computed tomography guidance for stereotactic localization","date_of_service":"2026-05-10","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":"31725","name":"Clearance of airways","description":"Catheter aspiration (separate procedure); tracheobronchial with fiberscope, bedside","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1395.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","date_of_service":"2026-05-10","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":"78701","name":"Kidney imaging with flow","description":"Kidney imaging morphology; with vascular flow","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-10","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":"65710","name":"Corneal transplant","description":"Keratoplasty (corneal transplant); anterior lamellar","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1073.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"92502","name":"Ear and throat examination","description":"Otolaryngologic examination under general anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77785","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-10","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":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"27001","name":"Tenotomy adductor hip open","description":"Tenotomy, adductor of hip, open","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22214","name":"Incis 1 vertebral seg lumbar","description":"Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; lumbar","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1313.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74020","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86788","name":"West nile virus ab igm","description":"Antibody; west nile virus, igm","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6563","name":"G com stckng waist30-40 cust","description":"Gradient compression stocking, waist length, 30-40 mmhg, custom, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"67415","name":"Aspiration orbital contents","description":"Fine needle aspiration of orbital contents","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76102","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3250","name":"Custom mold shoe remov prost","description":"Orthopedic footwear, custom molded shoe, removable inner mold, prosthetic shoe, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82042","name":"Other source albumin quan ea","description":"Albumin; other source, quantitative, each specimen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0605","name":"Repl batt lithium 4.5 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92275","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["BA","KG","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":"2026-05-10","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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"82247","name":"Bilirubin total","description":"Bilirubin; total","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"76529","name":"Echo exam of eye","description":"Ophthalmic ultrasonic foreign body localization","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2000","name":"Kafo sing fre stirr thi/calf","description":"Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L0631","name":"Lso sag r an/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76982","name":"Use 1st target lesion","description":"Ultrasound, elastography; first target lesion","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"27648","name":"Injection for ankle x-ray","description":"Injection procedure for ankle arthrography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":784.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75896","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":802.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3917","name":"Metacarp fx orthosis pre cst","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","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":"26860","name":"Fusion of finger joint","description":"Arthrodesis, interphalangeal joint, with or without internal fixation;","date_of_service":"2026-05-10","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":"64614","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"55500","name":"Removal of hydrocele","description":"Excision of hydrocele of spermatic cord, unilateral (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96900","name":"Actinotherapy uv light","description":"Actinotherapy (ultraviolet light)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78162","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33973","name":"Insert balloon device","description":"Insertion of intra-aortic balloon assist device through the ascending aorta","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":444.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47130","name":"Partial removal of liver","description":"Hepatectomy, resection of liver; total right lobectomy","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"27193","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6251","name":"Absorpt drg <=16 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29055","name":"Appl cast shoulder spica","description":"Application, cast; shoulder spica","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"69420","name":"Incision of eardrum","description":"Myringotomy including aspiration and/or eustachian tube inflation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78201","name":"Liver imaging static only","description":"Liver imaging; static only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64614","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43247","name":"Egd remove foreign body","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of foreign body(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"27372","name":"Removal of foreign body","description":"Removal of foreign body, deep, thigh region or knee area","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55875","name":"Transperi needle place pros","description":"Transperineal placement of needles or catheters into prostate for interstitial radioelement application, with or without cystoscopy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["26"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"87512","name":"Gardner vag dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); gardnerella vaginalis, quantification","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1020.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5220","name":"No knee joint with artic ali","description":"Above knee, short prosthesis, no knee joint (stubbies), with articulated ankle/foot, dynamically aligned, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1952","name":"Afo spiral prefab ots","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"61312","name":"Crnec/crnot sttl xdrl/sdrl","description":"Craniectomy or craniotomy for evacuation of hematoma, supratentorial; extradural or subdural","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65775","name":"Correction of astigmatism","description":"Corneal wedge resection for correction of surgically induced astigmatism","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59025","name":"Fetal non-stress test","description":"Fetal non-stress test","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"85018","name":"Hemoglobin","description":"Blood count; hemoglobin (hgb)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77790","name":"Radiation handling","description":"Supervision, handling, loading of radiation source","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0217","name":"Water circ heat pad w pump","description":"Water circulating heat pad with pump","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J7317","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"25105","name":"Remove wrist joint lining","description":"Arthrotomy, wrist joint; with synovectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":884.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"50070","name":"Nl comp cgen kdn abnormality","description":"Nephrolithotomy; complicated by congenital kidney abnormality","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1305.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"81015","name":"Microscopic exam of urine","description":"Urinalysis; microscopic only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96120","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74320","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01380","name":"Anes all clsd px knee joint","description":"Anesthesia for all closed procedures on knee joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"23800","name":"Arthrodesis glenohumeral jt","description":"Arthrodesis, glenohumeral joint;","date_of_service":"2026-05-10","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":"A4212","name":"Non coring needle or stylet","description":"Non-coring needle or stylet with or without catheter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47147","name":"Prep donor liver/arterial","description":"Backbench reconstruction of cadaver or living donor liver graft prior to allotransplantation; arterial anastomosis, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2624","name":"Hip adj flex ext abduct cont","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27592","name":"Amputate leg at thigh","description":"Amputation, thigh, through femur, any level; open, circular (guillotine)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":795.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80152","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"83950","name":"Oncoprotein her-2/neu","description":"Oncoprotein; her-2/neu","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"61880","name":"Revise/remove neuroelectrode","description":"Revision or removal of intracranial neurostimulator electrodes","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0275","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":990.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93931","name":"Upper extremity study","description":"Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80166","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2545","name":"Pentamidine non-comp unit","description":"Pentamidine isethionate, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per 300 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1614.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8702","name":"Ewhf s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00950","name":"Anes vag px culdoscopy","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); culdoscopy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":815.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70486","name":"Ct maxillofacial w/o dye","description":"Computed tomography, maxillofacial area; without contrast material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9503","name":"Tc99m medronate","description":"Technetium tc-99m medronate, diagnostic, per study dose, up to 30 millicuries","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"45339","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"75680","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"79005","name":"Nuclear rx oral admin","description":"Radiopharmaceutical therapy, by oral administration","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"33025","name":"Incision of heart sac","description":"Creation of pericardial window or partial resection for drainage","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"24802","name":"Arthrd elbow jt autog graft","description":"Arthrodesis, elbow joint; with autogenous graft (includes obtaining graft)","date_of_service":"2026-05-10","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":"45005","name":"Drainage of rectal abscess","description":"Incision and drainage of submucosal abscess, rectum","date_of_service":"2026-05-10","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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":786.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1110.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67040","name":"Laser treatment of retina","description":"Vitrectomy, mechanical, pars plana approach; with endolaser panretinal photocoagulation","date_of_service":"2026-05-10","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":"41114","name":"Excision of tongue lesion","description":"Excision of lesion of tongue with closure; with local tongue flap","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":740.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65265","name":"Remove foreign body from eye","description":"Removal of foreign body, intraocular; from posterior segment, nonmagnetic extraction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":655.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0450","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"64809","name":"Sympathectomy thoracolumbar","description":"Sympathectomy, thoracolumbar","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90750","name":"Hzv vacc recombinant im","description":"Zoster (shingles) vaccine (hzv), recombinant, subunit, adjuvanted, for intramuscular use","date_of_service":"2026-05-10","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":267.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99340","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82928","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36834","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5976","name":"Energy storing foot","description":"All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5700","name":"Replace socket below knee","description":"Replacement, socket, below knee, molded to patient model","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0433","name":"Portable liquid oxygen sys","description":"Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["MS"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26841","name":"Fusion of thumb","description":"Arthrodesis, carpometacarpal joint, thumb, with or without internal fixation;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19000","name":"Puncture aspir cyst breast","description":"Puncture aspiration of cyst of breast;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35621","name":"Bpg axillary-femoral","description":"Bypass graft, with other than vein; axillary-femoral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37765","name":"Stab phleb veins xtr 10-20","description":"Stab phlebectomy of varicose veins, 1 extremity; 10-20 stab incisions","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"35492","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69145","name":"Remove ear canal lesion(s)","description":"Excision soft tissue lesion, external auditory canal","date_of_service":"2026-05-10","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":"78468","name":"Heart infarct image (ef)","description":"Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"82776","name":"Galactose transferase test","description":"Galactose-1-phosphate uridyl transferase; screen","date_of_service":"2026-05-10","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":"92250","name":"Fundus photography w/i&r","description":"Fundus photography with interpretation and report","date_of_service":"2026-05-10","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":"76001","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0560","name":"Humidifier supplemental w/ i","description":"Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"57720","name":"Revision of cervix","description":"Trachelorrhaphy, plastic repair of uterine cervix, vaginal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"69110","name":"Remove external ear partial","description":"Excision external ear; partial, simple repair","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33645","name":"Revision of heart veins","description":"Direct or patch closure, sinus venosus, with or without anomalous pulmonary venous drainage","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1505.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82487","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"78428","name":"Cardiac shunt imaging","description":"Cardiac shunt detection","date_of_service":"2026-05-10","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":"85097","name":"Bone marrow interpretation","description":"Bone marrow, smear interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":765.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31527","name":"Laryngoscopy for treatment","description":"Laryngoscopy direct, with or without tracheoscopy; with insertion of obturator","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71021","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-10","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":"77014","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6512","name":"Compres burn garment, noc","description":"Compression burn garment, not otherwise classified","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1092.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1298","name":"Wheelchair spec seat depth/w","description":"Special wheelchair seat depth and/or width, by construction","date_of_service":"2026-05-10","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":"87164","name":"Dark field exam spec collj","description":"Dark field examination, any source (eg, penile, vaginal, oral, skin); includes specimen collection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1091.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77059","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"43258","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83893","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"84061","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0639","name":"Lso s/c shell/panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["26"]}],"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":"2026-05-10","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":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"19364","name":"Brst rcnstj free flap","description":"Breast reconstruction; with free flap (eg, ftram, diep, siea, gap flap)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3188.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":703.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"33611","name":"Repair double ventricle","description":"Repair of double outlet right ventricle with intraventricular tunnel repair;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97004","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"61500","name":"Crnec exc tum/bone les skull","description":"Craniectomy; with excision of tumor or other bone lesion of skull","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1502.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82585","name":"Assay of cryofibrinogen","description":"Cryofibrinogen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-05-10","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":"75820","name":"Vein x-ray arm/leg","description":"Venography, extremity, unilateral, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77052","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-10","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":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","date_of_service":"2026-05-10","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":"86808","name":"Cytotoxic antibody screening","description":"Serum screening for cytotoxic percent reactive antibody (pra); quick method","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5822","name":"Endo knee-shin pneum swg frc","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"72069","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78598","name":"Lung perf&ventilat diferentl","description":"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31240","name":"Nsl/sns ndsc cnch bull rescj","description":"Nasal/sinus endoscopy, surgical; with concha bullosa resection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72052","name":"X-ray exam neck spine 6/>vws","description":"Radiologic examination, spine, cervical; 6 or more views","date_of_service":"2026-05-10","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":"78121","name":"Red cell mass multiple","description":"Red cell volume determination (separate procedure); multiple samplings","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1680","name":"Pelvic & hip control thigh c","description":"Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"64435","name":"Njx aa&/strd paracrv nrv","description":"Injection(s), anesthetic agent(s) and/or steroid; paracervical (uterine) nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94250","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53430","name":"Reconstruction of urethra","description":"Urethroplasty, reconstruction of female urethra","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0744","name":"Neuromuscular stim for scoli","description":"Neuromuscular stimulator for scoliosis","date_of_service":"2026-05-10","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":"92575","name":"Sensorineural acuity lvl tst","description":"Sensorineural acuity level test","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2125.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0635","name":"Patient lift electric","description":"Patient lift, electric with seat or sling","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","date_of_service":"2026-05-10","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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21495","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1235","name":"Rigid ped wc adjustable","description":"Wheelchair, pediatric size, rigid, adjustable, with seating system","date_of_service":"2026-05-10","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":"93014","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19260","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1294.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1867.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42145","name":"Repair palate pharynx/uvula","description":"Palatopharyngoplasty (eg, uvulopalatopharyngoplasty, uvulopharyngoplasty)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2303","name":"Lens sphcy trifocal 4.0/.12-","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90467","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"J9270","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9268","name":"Pentostatin injection","description":"Injection, pentostatin, 10 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1870.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73020","name":"X-ray exam of shoulder","description":"Radiologic examination, shoulder; 1 view","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2341","name":"W/c wdth 24-27 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50688","name":"Change of ureter tube/stent","description":"Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"82541","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1841.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1235","name":"Rigid ped wc adjustable","description":"Wheelchair, pediatric size, rigid, adjustable, with seating system","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2905.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46600","name":"Diagnostic anoscopy spx","description":"Anoscopy; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-05-10","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":"83915","name":"Assay of nucleotidase","description":"Nucleotidase 5-","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1356.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75970","name":"Vascular biopsy","description":"Transcatheter biopsy, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1845.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86141","name":"C-reactive protein hs","description":"C-reactive protein; high sensitivity (hscrp)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4353","name":"Intermittent urinary cath","description":"Intermittent urinary catheter, with insertion supplies","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":724.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0970","name":"Tlso corset front","description":"Tlso, corset front","date_of_service":"2026-05-10","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":"70130","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; complete, minimum of 3 views per side","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":"78445","name":"Vascular flow imaging","description":"Non-cardiac vascular flow imaging (ie, angiography, venography)","date_of_service":"2026-05-10","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":"72193","name":"Ct pelvis w/dye","description":"Computed tomography, pelvis; with contrast material(s)","date_of_service":"2026-05-10","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":"71020","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78730","name":"Urinary bladder retention","description":"Urinary bladder residual study (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","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":"63050","name":"Cervical laminoplsty 2/> seg","description":"Laminoplasty, cervical, with decompression of the spinal cord, 2 or more vertebral segments;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":653.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6224","name":"Gauze > 48 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73552","name":"X-ray exam of femur 2/>","description":"Radiologic examination, femur; minimum 2 views","date_of_service":"2026-05-10","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":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7185","name":"Electron elbow adolescent sw","description":"Electronic elbow, adolescent, variety village or equal, switch controlled","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"74450","name":"X-ray urethra/bladder","description":"Urethrocystography, retrograde, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"82055","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"94750","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"E1083","name":"Hemi-wheelchair fixed arms","description":"Hemi-wheelchair, fixed full length arms, swing away detachable elevating leg rest","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31613","name":"Tracheostoma revj simple","description":"Tracheostoma revision; simple, without flap rotation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77058","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32098","name":"Open biopsy of lung pleura","description":"Thoracotomy, with biopsy(ies) of pleura","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68745","name":"Create tear duct drain","description":"Conjunctivorhinostomy (fistulization of conjunctiva to nasal cavity); without tube","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95928","name":"C motor evoked uppr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); upper limbs","date_of_service":"2026-05-10","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":"47564","name":"Laparo cholecystectomy/explr","description":"Laparoscopy, surgical; cholecystectomy with exploration of common duct","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28208","name":"Repair of foot tendon","description":"Repair, tendon, extensor, foot; primary or secondary, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94772","name":"Circadian respir pattern rec","description":"Circadian respiratory pattern recording (pediatric pneumogram), 12-24 hour continuous recording, infant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78290","name":"Intestine imaging","description":"Intestine imaging (eg, ectopic gastric mucosa, meckels localization, volvulus)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69620","name":"Myringoplasty","description":"Myringoplasty (surgery confined to drumhead and donor area)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"24566","name":"Prq skel fix epcndylr hum fx","description":"Percutaneous skeletal fixation of humeral epicondylar fracture, medial or lateral, with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1298","name":"Wheelchair spec seat depth/w","description":"Special wheelchair seat depth and/or width, by construction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"72195","name":"Mri pelvis w/o dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-10","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":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71021","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0572","name":"Aerosol compressor adjust pr","description":"Aerosol compressor, adjustable pressure, light duty for intermittent use","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"37209","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"56605","name":"Biopsy of vulva/perineum","description":"Biopsy of vulva or perineum (separate procedure); 1 lesion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"64858","name":"Repair sciatic nerve","description":"Suture of sciatic nerve","date_of_service":"2026-05-10","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":"89321","name":"Semen anal sperm detection","description":"Semen analysis; sperm presence and motility of sperm, if performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0740","name":"Non-implant pelv flr e-stim","description":"Non-implanted pelvic floor electrical stimulator, complete system","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75733","name":"Artery x-rays adrenals","description":"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"99301","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78587","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80196","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96377","name":"Applicaton on-body injector","description":"Application of on-body injector (includes cannula insertion) for timed subcutaneous injection","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"27635","name":"Remove lower leg bone lesion","description":"Excision or curettage of bone cyst or benign tumor, tibia or fibula;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57295","name":"Revise vag graft via vagina","description":"Revision (including removal) of prosthetic vaginal graft; vaginal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1427.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"72240","name":"Myelography neck spine","description":"Myelography, cervical, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"84100","name":"Assay of phosphorus","description":"Phosphorus inorganic (phosphate);","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"28575","name":"Treat foot dislocation","description":"Closed treatment of talotarsal joint dislocation; requiring anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83715","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86331","name":"Immunodiffusion ouchterlony","description":"Immunodiffusion; gel diffusion, qualitative (ouchterlony), each antigen or antibody","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"L3221","name":"Orthopedic mens shoes dpth i","description":"Orthopedic footwear, mens shoe, depth inlay, each","date_of_service":"2026-05-10","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":"82000","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43243","name":"Egd injection varices","description":"Esophagogastroduodenoscopy, flexible, transoral; with injection sclerosis of esophageal/gastric varices","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85008","name":"Bl smear w/o diff wbc count","description":"Blood count; blood smear, microscopic examination without manual differential wbc count","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"29700","name":"Rmvl/bivlv gauntlet boot/cst","description":"Removal or bivalving; gauntlet, boot or body cast","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0603","name":"Repl batt alkaline 1.5 v","description":"Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"00620","name":"Anes px thrc spine&cord nos","description":"Anesthesia for procedures on thoracic spine and cord, not otherwise specified","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5657","name":"Add low ext man aut vol any","description":"Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3381.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01112","name":"Anes bone marrow aspir&/bx","description":"Anesthesia for bone marrow aspiration and/or biopsy, anterior or posterior iliac crest","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"82365","name":"Calculus spectroscopy","description":"Calculus; infrared spectroscopy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1164.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"86778","name":"Toxoplasma antibody igm","description":"Antibody; toxoplasma, igm","date_of_service":"2026-05-10","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":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"54650","name":"Orchiopexy (fowler-stephens)","description":"Orchiopexy, abdominal approach, for intra-abdominal testis (eg, fowler-stephens)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33978","name":"Remove ventricular device","description":"Removal of ventricular assist device; extracorporeal, biventricular","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1157.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72110","name":"X-ray exam l-2 spine 4/>vws","description":"Radiologic examination, spine, lumbosacral; minimum of 4 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46083","name":"Inc thrombosed hroid xtrnl","description":"Incision of thrombosed hemorrhoid, external","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70260","name":"X-ray exam of skull","description":"Radiologic examination, skull; complete, minimum of 4 views","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"95834","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15400","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95958","name":"Eeg monitoring/function test","description":"Wada activation test for hemispheric function, including electroencephalographic (eeg) monitoring","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27415","name":"Osteochondral knee allograft","description":"Osteochondral allograft, knee, open","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"85635","name":"Reptilase test","description":"Reptilase test","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"44300","name":"Open bowel to skin","description":"Placement, enterostomy or cecostomy, tube open (eg, for feeding or decompression) (separate procedure)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6527","name":"G garmt full leg/ft nght cus","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"63170","name":"Incise spinal cord tract(s)","description":"Laminectomy with myelotomy (eg, bischof or drez type), cervical, thoracic, or thoracolumbar","date_of_service":"2026-05-10","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":"27510","name":"Treatment of thigh fracture","description":"Closed treatment of femoral fracture, distal end, medial or lateral condyle, with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"77776","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77789","name":"Apply surf ldr radionuclide","description":"Surface application of low dose rate radionuclide source","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49201","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1051.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"26525","name":"Release finger contracture","description":"Capsulectomy or capsulotomy; interphalangeal joint, each joint","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1420.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0761","name":"Nontherm electromgntc device","description":"Non-thermal pulsed high frequency radiowaves, high peak power electromagnetic energy treatment device","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q0493","name":"Emr pwr cbl combo vad, rep","description":"Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92977","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0480","name":"Tlso rigid plastic custom fa","description":"Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, res","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1844","name":"Ko w/adj jt rot cntrl molded","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"92235","name":"Fluorescein angrph mltiframe","description":"Fluorescein angiography (includes multiframe imaging) with interpretation and report, unilateral or bilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1421.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KF"]}],"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":"2026-05-10","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":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G0367","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E8001","name":"Upright gait trainer","description":"Gait trainer, pediatric size, upright support, includes all accessories and components","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44141","name":"Partial removal of colon","description":"Colectomy, partial; with skin level cecostomy or colostomy","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"76705","name":"Echo exam of abdomen","description":"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up)","date_of_service":"2026-05-10","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":"E0761","name":"Nontherm electromgntc device","description":"Non-thermal pulsed high frequency radiowaves, high peak power electromagnetic energy treatment device","date_of_service":"2026-05-10","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":"43234","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1805.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"60260","name":"Repeat thyroid surgery","description":"Thyroidectomy, removal of all remaining thyroid tissue following previous removal of a portion of thyroid","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1246.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"11975","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":863.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","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":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0461","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"35535","name":"Art byp grft hepatorenal","description":"Bypass graft, with vein; hepatorenal","date_of_service":"2026-05-10","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":"29821","name":"Sho arthrs srg compl synvct","description":"Arthroscopy, shoulder, surgical; synovectomy, complete","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4419","name":"Ost pch for bar w flange/flt","description":"Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each","date_of_service":"2026-05-10","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":"57513","name":"Laser surgery of cervix","description":"Cautery of cervix; laser ablation","date_of_service":"2026-05-10","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":"94642","name":"Aerosol inhalation treatment","description":"Aerosol inhalation of pentamidine for pneumocystis carinii pneumonia treatment or prophylaxis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","date_of_service":"2026-05-10","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":"00450","name":"Anes px clav&scapula nos","description":"Anesthesia for procedures on clavicle and scapula; not otherwise specified","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-10","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":"90845","name":"Psychoanalysis","description":"Psychoanalysis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92591","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":758.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"13160","name":"Sec clsr surg wnd/dehsn xtn","description":"Secondary closure of surgical wound or dehiscence, extensive or complicated","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"21206","name":"Reconstruct upper jaw bone","description":"Osteotomy, maxilla, segmental (eg, wassmund or schuchard)","date_of_service":"2026-05-10","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":"27425","name":"Lat retinacular release open","description":"Lateral retinacular release, open","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1690.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"92564","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"L0488","name":"Tlso rigid lined pre one pie","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","date_of_service":"2026-05-10","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":"24346","name":"Reconstruct elbow med ligmnt","description":"Reconstruction medial collateral ligament, elbow, with tendon graft (includes harvesting of graft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2017.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29125","name":"Appl short arm splint static","description":"Application of short arm splint (forearm to hand); static","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78271","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58825","name":"Transposition ovary(s)","description":"Transposition, ovary(s)","date_of_service":"2026-05-10","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":"26600","name":"Treat metacarpal fracture","description":"Closed treatment of metacarpal fracture, single; without manipulation, each bone","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"75887","name":"Vein x-ray liver w/o hemodyn","description":"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"32653","name":"Thoracoscopy remov fb/fibrin","description":"Thoracoscopy, surgical; with removal of intrapleural foreign body or fibrin deposit","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37790","name":"Penile venous occlusion","description":"Penile venous occlusive procedure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2610","name":"Hip clevis/thrust bearing lo","description":"Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10838.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"56805","name":"Clitoroplasty intersex state","description":"Clitoroplasty for intersex state","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"29848","name":"Wrist endoscopy/surgery","description":"Endoscopy, wrist, surgical, with release of transverse carpal ligament","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"P9047","name":"Albumin (human), 25%, 50ml","description":"Infusion, albumin (human), 25%, 50 ml","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"V5010","name":"Assessment for hearing aid","description":"Assessment for hearing aid","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"74000","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"00164","name":"Anes px nose&sins bx sft tis","description":"Anesthesia for procedures on nose and accessory sinuses; biopsy, soft tissue","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1274.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1601.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":550.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2047.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2251.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84377","name":"Sugars multiple qual","description":"Sugars (mono-, di-, and oligosaccharides); multiple qualitative, each specimen","date_of_service":"2026-05-10","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":"90911","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0169","name":"Promethazine hcl 12.5mg oral","description":"Promethazine hydrochloride, 12.5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6442","name":"Conform band n/s w<3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2134","name":"Kafo fem fx cast semi-rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":674.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28341","name":"Resect enlarged toe","description":"Reconstruction, toe, macrodactyly; requiring bone resection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"84510","name":"Assay of tyrosine","description":"Tyrosine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"27732","name":"Repair of fibula epiphysis","description":"Arrest, epiphyseal (epiphysiodesis), open; distal fibula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97034","name":"App mdlty 1+cntrst bth ea 15","description":"Application of a modality to 1 or more areas; contrast baths, each 15 minutes","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1491.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"01966","name":"Anes induced abortion px","description":"Anesthesia for induced abortion procedures","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73050","name":"X-ray exam of shoulders","description":"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78715","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00866","name":"Anes xtrprt lw abd adrnlctmy","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; adrenalectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9612","name":"Catheterize for urine spec","description":"Catheterization for collection of specimen, single patient, all places of service","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"31237","name":"Nsl/sins ndsc surg bx polypc","description":"Nasal/sinus endoscopy, surgical; with biopsy, polypectomy or debridement (separate procedure)","date_of_service":"2026-05-10","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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-10","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":"K0734","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33310","name":"Exploratory heart surgery","description":"Cardiotomy, exploratory (includes removal of foreign body, atrial or ventricular thrombus); without bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1375.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"26852","name":"Fusion of knuckle with graft","description":"Arthrodesis, metacarpophalangeal joint, with or without internal fixation; with autograft (includes obtaining graft)","date_of_service":"2026-05-10","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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-10","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":"70320","name":"Full mouth x-ray of teeth","description":"Radiologic examination, teeth; complete, full mouth","date_of_service":"2026-05-10","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":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44147","name":"Partial removal of colon","description":"Colectomy, partial; abdominal and transanal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1971.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":856.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88347","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75561","name":"Cardiac mri for morph w/dye","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast material(s) and further sequences;","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86378","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92586","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"83727","name":"Assay of lrh hormone","description":"Luteinizing releasing factor (lrh)","date_of_service":"2026-05-10","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":"33960","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"76088","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3182.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1095.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61313","name":"Crnec/crnot sttl icere","description":"Craniectomy or craniotomy for evacuation of hematoma, supratentorial; intracerebral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","date_of_service":"2026-05-10","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":"76872","name":"Us transrectal","description":"Ultrasound, transrectal;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62145","name":"Repair of skull & brain","description":"Cranioplasty for skull defect with reparative brain surgery","date_of_service":"2026-05-10","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":"65222","name":"Remove foreign body from eye","description":"Removal of foreign body, external eye; corneal, with slit lamp","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1420.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"95933","name":"Blink reflex test","description":"Orbicularis oculi (blink) reflex, by electrodiagnostic testing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"28755","name":"Fusion of big toe joint","description":"Arthrodesis, great toe; interphalangeal joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1041.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"82382","name":"Assay urine catecholamines","description":"Catecholamines; total urine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6196","name":"Alginate dressing <=16 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"48000","name":"Drainage of abdomen","description":"Placement of drains, peripancreatic, for acute pancreatitis;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1905.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5160","name":"Mold socket bent knee shin s","description":"Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76800","name":"Us exam spinal canal","description":"Ultrasound, spinal canal and contents","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":763.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74018","name":"Radex abdomen 1 view","description":"Radiologic examination, abdomen; 1 view","date_of_service":"2026-05-10","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":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33513","name":"Cabg vein four","description":"Coronary artery bypass, vein only; 4 coronary venous grafts","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2157.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"11451","name":"Exc skn hdrdnt ax complex","description":"Excision of skin and subcutaneous tissue for hidradenitis, axillary; with complex repair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0450","name":"Tlso flex trunk/thor pre ots","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"96111","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":907.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24151","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":839.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53850","name":"Prostatic microwave thermotx","description":"Transurethral destruction of prostate tissue; by microwave thermotherapy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1258.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G2066","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0349","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50393","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"30125","name":"Removal of nose lesion","description":"Excision dermoid cyst, nose; complex, under bone or cartilage","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24565","name":"Cltx hum epcndylr fx w/mnpj","description":"Closed treatment of humeral epicondylar fracture, medial or lateral; with manipulation","date_of_service":"2026-05-10","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":"0144A","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84704","name":"Hcg free betachain test","description":"Gonadotropin, chorionic (hcg); free beta chain","date_of_service":"2026-05-10","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":"92611","name":"Motion fluoroscopy/swallow","description":"Motion fluoroscopic evaluation of swallowing function by cine or video recording","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57240","name":"Anterior colporrhaphy","description":"Anterior colporrhaphy, repair of cystocele with or without repair of urethrocele, including cystourethroscopy, when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82977","name":"Assay of ggt","description":"Glutamyltransferase, gamma (ggt)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5613","name":"Ak 4 bar ling w/hydraul swig","description":"Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":454.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21601","name":"Exc chest wall tumor w/ribs","description":"Excision of chest wall tumor including rib(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1020.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91322","name":"Sarscov2 vac 50 mcg/0.5ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 50 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","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":129.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2106","name":"Afo tib fx cast plaster mold","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"29046","name":"Appl bdy cst sho to hip b th","description":"Application of body cast, shoulder to hips; including both thighs","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27054","name":"Removal of hip joint lining","description":"Arthrotomy with synovectomy, hip joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":793.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"87299","name":"Antibody detection nos if","description":"Infectious agent antigen detection by immunofluorescent technique; not otherwise specified, each organism","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15780","name":"Dermabrasion total face","description":"Dermabrasion; total face (eg, for acne scarring, fine wrinkling, rhytids, general keratosis)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":542.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72128","name":"Ct chest spine w/o dye","description":"Computed tomography, thoracic spine; without contrast material","date_of_service":"2026-05-10","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":"G0307","name":"Cbc without platelet","description":"Complete (cbc), automated (hgb, hct, rbc, wbc; without platelet count)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5400","name":"Postop dress & 1 cast chg bk","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"88161","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; preparation, screening and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"H0049","name":"Alcohol/drug screening","description":"Alcohol and/or drug screening","date_of_service":"2026-05-10","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":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"70160","name":"X-ray exam of nasal bones","description":"Radiologic examination, nasal bones, complete, minimum of 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4268","name":"Female condom","description":"Contraceptive supply, condom, female, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00102","name":"Anes px plstc rpr cleft lip","description":"Anesthesia for procedures involving plastic repair of cleft lip","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"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":"2026-05-10","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":"72126","name":"Ct neck spine w/dye","description":"Computed tomography, cervical spine; with contrast material","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69705","name":"Nps surg dilat eust tube uni","description":"Nasopharyngoscopy, surgical, with dilation of eustachian tube (ie, balloon dilation); unilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29550","name":"Strapping of toes","description":"Strapping; toes","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"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":"84165","name":"Protein e-phoresis serum","description":"Protein; electrophoretic fractionation and quantitation, serum","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1756.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1385.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1038","name":"Transport chair pt wt<=300lb","description":"Transport chair, adult size, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"96117","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"75996","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":641.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1452","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":583.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35860","name":"Explore limb vessels","description":"Exploration for postoperative hemorrhage, thrombosis or infection; extremity","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":733.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32657","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91012","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3546.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU","KF",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95955","name":"Eeg during surgery","description":"Electroencephalogram (eeg) during nonintracranial surgery (eg, carotid surgery)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86777","name":"Toxoplasma antibody","description":"Antibody; toxoplasma","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77054","name":"X-ray of mammary ducts","description":"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"82523","name":"Collagen crosslinks","description":"Collagen cross links, any method","date_of_service":"2026-05-10","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":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"A4604","name":"Tubing with heating element","description":"Tubing with integrated heating element for use with positive airway pressure device","date_of_service":"2026-05-10","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":"91105","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"86628","name":"Candida antibody","description":"Antibody; candida","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"50722","name":"Release of ureter","description":"Ureterolysis for ovarian vein syndrome","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2064.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0416","name":"Prostate biopsy, any mthd","description":"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method","date_of_service":"2026-05-10","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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1200","name":"Wheelchair amputee fixed arm","description":"Amputee wheelchair, fixed full length arms, swing away detachable footrest","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":653.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1670.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83690","name":"Assay of lipase","description":"Lipase","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"50500","name":"Repair of kidney wound","description":"Nephrorrhaphy, suture of kidney wound or injury","date_of_service":"2026-05-10","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":"A4316","name":"Cath w/drainage 3-way","description":"Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E0880","name":"Trac stand free stand extrem","description":"Traction stand, free standing, extremity traction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65850","name":"Trabeculotomy ab externo","description":"Trabeculotomy ab externo","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":506.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27400","name":"Revise thigh muscles/tendons","description":"Transfer, tendon or muscle, hamstrings to femur (eg, eggers type procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00566","name":"Anes direct cabg w/o pump","description":"Anesthesia for direct coronary artery bypass grafting; without pump oxygenator","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":604.76,"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-10","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":"77086","name":"Vrt fracture assmt via dxa","description":"Vertebral fracture assessment via dual-energy x-ray absorptiometry (dxa)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86762","name":"Rubella antibody","description":"Antibody; rubella","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4415","name":"Ost skn barr w/o conv >4 sqi","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"68420","name":"I&d lacrimal sac","description":"Incision, drainage of lacrimal sac (dacryocystotomy or dacryocystostomy)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90808","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93979","name":"Vascular study","description":"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"19291","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":898.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95950","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"84233","name":"Assay of estrogen","description":"Receptor assay; estrogen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0249T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25922","name":"Amputate hand at wrist","description":"Disarticulation through wrist; secondary closure or scar revision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":711.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":425.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1433.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"87621","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP19","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77326","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1845","name":"Ko double upright pre cst","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86430","name":"Rheumatoid factor test qual","description":"Rheumatoid factor; qualitative","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84439","name":"Assay of free thyroxine","description":"Thyroxine; free","date_of_service":"2026-05-10","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":"78458","name":"Ven thrombosis images bilat","description":"Venous thrombosis imaging, venogram; bilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1478.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"56515","name":"Destroy vulva lesion/s compl","description":"Destruction of lesion(s), vulva; extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"65110","name":"Removal of eye","description":"Exenteration of orbit (does not include skin graft), removal of orbital contents; only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":766.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84446","name":"Assay of vitamin e","description":"Tocopherol alpha (vitamin e)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-05-10","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":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"76946","name":"Echo guide for amniocentesis","description":"Ultrasonic guidance for amniocentesis, imaging supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"29358","name":"Appl long leg cast brace","description":"Application of long leg cast brace","date_of_service":"2026-05-10","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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"31382","name":"Partial removal of larynx","description":"Partial laryngectomy (hemilaryngectomy); antero-latero-vertical","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23140","name":"Removal of bone lesion","description":"Excision or curettage of bone cyst or benign tumor of clavicle or scapula;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":597.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"96372","name":"Ther/proph/diag inj sc/im","description":"Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3905","name":"Who w/nontorsion jnt(s) cf","description":"Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"23462","name":"Repair shoulder capsule","description":"Capsulorrhaphy, anterior, any type; with coracoid process transfer","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1303.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"42725","name":"I&d absc phrngl xtrnl appr","description":"Incision and drainage abscess; retropharyngeal or parapharyngeal, external approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25370","name":"Revise radius or ulna","description":"Multiple osteotomies, with realignment on intramedullary rod (sofield type procedure); radius or ulna","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67040","name":"Laser treatment of retina","description":"Vitrectomy, mechanical, pars plana approach; with endolaser panretinal photocoagulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92993","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80162","name":"Assay of digoxin total","description":"Digoxin; total","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85244","name":"Clot factor viii reltd antgn","description":"Clotting; factor viii related antigen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"25400","name":"Repair radius or ulna","description":"Repair of nonunion or malunion, radius or ulna; without graft (eg, compression technique)","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"93562","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"35251","name":"Rpr blvsl vn grf intra-abdl","description":"Repair blood vessel with vein graft; intra-abdominal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25210","name":"Removal of wrist bone","description":"Carpectomy; 1 bone","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76965","name":"Echo guidance radiotherapy","description":"Ultrasonic guidance for interstitial radioelement application","date_of_service":"2026-05-10","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":"J2850","name":"Inj secretin synthetic human","description":"Injection, secretin, synthetic, human, 1 microgram","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2337.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":985.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"86674","name":"Giardia lamblia antibody","description":"Antibody; giardia lamblia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5570","name":"Prep ak ischial direct form","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4427","name":"Ost pch drain/barr lk flng/f","description":"Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1355.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["TC"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90826","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7026","name":"Replace chst cmprss sys hose","description":"High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1268.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1391.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"86682","name":"Helminth antibody","description":"Antibody; helminth, not elsewhere specified","date_of_service":"2026-05-10","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":"Q0484","name":"Monitor elec or comb vad rep","description":"Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"95875","name":"Limb exercise test","description":"Ischemic limb exercise test with serial specimen(s) acquisition for muscle(s) metabolite(s)","date_of_service":"2026-05-10","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":"22830","name":"Exploration of spinal fusion","description":"Exploration of spinal fusion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86335","name":"Immunfix e-phorsis/urine/csf","description":"Immunofixation electrophoresis; other fluids with concentration (eg, urine, csf)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"64425","name":"Njx aa&/strd ii ih nerves","description":"Injection(s), anesthetic agent(s) and/or steroid; ilioinguinal, iliohypogastric nerves","date_of_service":"2026-05-10","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":"51060","name":"Removal of ureter stone","description":"Transvesical ureterolithotomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6695","name":"Elbow socket ins use w/o lck","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"46045","name":"I&d absc tranal under anes","description":"Incision and drainage of intramural, intramuscular, or submucosal abscess, transanal, under anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"97018","name":"Paraffin bath therapy","description":"Application of a modality to 1 or more areas; paraffin bath","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","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":"21462","name":"Optx mndblr fx w/ntrdntl","description":"Open treatment of mandibular fracture; with interdental fixation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1087.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3931","name":"Whfo nontorsion joint prefab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"B9002","name":"Enter nutr inf pump any type","description":"Enteral nutrition infusion pump, any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1652","name":"Ho bi thighcuffs w sprdr bar","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1570","name":"Ganciclovir sodium injection","description":"Injection, ganciclovir sodium, 500 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"72110","name":"X-ray exam l-2 spine 4/>vws","description":"Radiologic examination, spine, lumbosacral; minimum of 4 views","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"25065","name":"Biopsy forearm soft tissues","description":"Biopsy, soft tissue of forearm and/or wrist; superficial","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5690","name":"Bk waist belt padded and lin","description":"Addition to lower extremity, below knee, waist belt, padded and lined","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86631","name":"Chlamydia antibody","description":"Antibody; chlamydia","date_of_service":"2026-05-10","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":"E0749","name":"Elec osteogen stim implanted","description":"Osteogenesis stimulator, electrical, surgically implanted","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61253","name":"Burr hole treph ittl uni/bi","description":"Burr hole(s) or trephine, infratentorial, unilateral or bilateral","date_of_service":"2026-05-10","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":"95012","name":"Nitric oxide exp gas deter","description":"Nitric oxide expired gas determination","date_of_service":"2026-05-10","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":"78111","name":"Plasma volume multiple","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5830","name":"Endo knee-shin pneum/swg pha","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50783","name":"Reimplant ureter in bladder","description":"Ureteroneocystostomy; with extensive ureteral tailoring","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73660","name":"X-ray exam of toe(s)","description":"Radiologic examination; toe(s), minimum of 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KM"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"37616","name":"Ligation major artery chest","description":"Ligation, major artery (eg, post-traumatic, rupture); chest","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1204.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1912.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95868","name":"Ndl emg cranial nrv musc bi","description":"Needle electromyography; cranial nerve supplied muscles, bilateral","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU","59",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S8421","name":"Ready gradient sleev/glov","description":"Gradient pressure aid (sleeve and glove combination), ready made","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82164","name":"Angiotensin i enzyme test","description":"Angiotensin i - converting enzyme (ace)","date_of_service":"2026-05-10","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":"E0249","name":"Pad water circulating heat u","description":"Pad for water circulating heat unit, for replacement only","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"78015","name":"Thyroid met imaging","description":"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01462","name":"Anes clsd px lower l/a/f","description":"Anesthesia for all closed procedures on lower leg, ankle, and foot","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"57240","name":"Anterior colporrhaphy","description":"Anterior colporrhaphy, repair of cystocele with or without repair of urethrocele, including cystourethroscopy, when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83080","name":"Assay of b hexosaminidase ea","description":"B-hexosaminidase, each assay","date_of_service":"2026-05-10","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":"75660","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4314","name":"Cath w/drainage 2-way latex","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","date_of_service":"2026-05-10","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":"E0434","name":"Portable liquid 02","description":"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["QB","RR","QF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"84133","name":"Assay of urine potassium","description":"Potassium; urine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","date_of_service":"2026-05-10","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":"29126","name":"Appl short arm splint dyn","description":"Application of short arm splint (forearm to hand); dynamic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"93970","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study","date_of_service":"2026-05-10","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":"35633","name":"Bpg ilio-mesenteric","description":"Bypass graft, with other than vein; ilio-mesenteric","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78466","name":"Heart infarct image","description":"Myocardial imaging, infarct avid, planar; qualitative or quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6384","name":"Postop dsg cast chg shlder/t","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-05-10","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":"50526","name":"Close nephrovisceral fistula","description":"Closure of nephrovisceral fistula (eg, renocolic), including visceral repair; thoracic approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1567.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":717.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57282","name":"Colpopexy extraperitoneal","description":"Colpopexy, vaginal; extra-peritoneal approach (sacrospinous, iliococcygeus)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"A6234","name":"Hydrocolld drg <=16 w/o bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"76872","name":"Us transrectal","description":"Ultrasound, transrectal;","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1039.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64704","name":"Revise hand/foot nerve","description":"Neuroplasty; nerve of hand or foot","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"B4082","name":"Enteral ng tubing w/o stylet","description":"Nasogastric tubing without stylet","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"86602","name":"Antinomyces antibody","description":"Antibody; actinomyces","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":"E0459","name":"Chest wrap","description":"Chest wrap","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"35452","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":462.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"61880","name":"Revise/remove neuroelectrode","description":"Revision or removal of intracranial neurostimulator electrodes","date_of_service":"2026-05-10","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":"64774","name":"Remove skin nerve lesion","description":"Excision of neuroma; cutaneous nerve, surgically identifiable","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30580","name":"Repair upper jaw fistula","description":"Repair fistula; oromaxillary (combine with 31030 if antrotomy is included)","date_of_service":"2026-05-10","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":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","date_of_service":"2026-05-10","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":"56442","name":"Hymenotomy","description":"Hymenotomy, simple incision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88314","name":"Histochemical stains add-on","description":"Special stain including interpretation and report; histochemical stain on frozen tissue block (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0749","name":"Elec osteogen stim implanted","description":"Osteogenesis stimulator, electrical, surgically implanted","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KF"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"29040","name":"Appl bdy cst sho to hip head","description":"Application of body cast, shoulder to hips; including head, minerva type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93230","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"59151","name":"Treat ectopic pregnancy","description":"Laparoscopic treatment of ectopic pregnancy; with salpingectomy and/or oophorectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":934.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"41016","name":"Drainage of mouth lesion","description":"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; submental","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83883","name":"Assay nephelometry not spec","description":"Nephelometry, each analyte not elsewhere specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01742","name":"Anes opn/arthrs elbw osteot","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; osteotomy of humerus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"84234","name":"Assay of progesterone","description":"Receptor assay; progesterone","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"79200","name":"Nuclear rx intracav admin","description":"Radiopharmaceutical therapy, by intracavitary administration","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92541","name":"Spontaneous nystagmus test","description":"Spontaneous nystagmus test, including gaze and fixation nystagmus, with recording","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75557","name":"Cardiac mri for morph","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"62120","name":"Repair skull cavity lesion","description":"Repair of encephalocele, skull vault, including cranioplasty","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1245.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7401","name":"Add ue prost a/e ultlite mat","description":"Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70015","name":"Contrast x-ray of brain","description":"Cisternography, positive contrast, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0762","name":"Trans elec jt stim dev sys","description":"Transcutaneous electrical joint stimulation device system, includes all accessories","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0585","name":"Nebulizer w/ compressor & he","description":"Nebulizer, with compressor and heater","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"27079","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"31254","name":"Nsl/sins ndsc w/prtl ethmdct","description":"Nasal/sinus endoscopy, surgical with ethmoidectomy; partial (anterior)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"27385","name":"Repair of thigh muscle","description":"Suture of quadriceps or hamstring muscle rupture; primary","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61870","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3701","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"33203","name":"Insert epicard eltrd endo","description":"Insertion of epicardial electrode(s); endoscopic approach (eg, thoracoscopy, pericardioscopy)","date_of_service":"2026-05-10","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":"24579","name":"Optx humrl cndylr fracture","description":"Open treatment of humeral condylar fracture, medial or lateral, includes internal fixation, when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83630","name":"Lactoferrin fecal (qual)","description":"Lactoferrin, fecal; qualitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78598","name":"Lung perf&ventilat diferentl","description":"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49061","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"37200","name":"Transcatheter biopsy","description":"Transcatheter biopsy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27654","name":"Repair of achilles tendon","description":"Repair, secondary, achilles tendon, with or without graft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":849.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1462.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75791","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"35761","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"64550","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4356","name":"Ext ureth clmp or compr dvc","description":"External urethral clamp or compression device (not to be used for catheter clamp), each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","date_of_service":"2026-05-10","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":"96155","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"70240","name":"X-ray exam pituitary saddle","description":"Radiologic examination, sella turcica","date_of_service":"2026-05-10","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":"72052","name":"X-ray exam neck spine 6/>vws","description":"Radiologic examination, spine, cervical; 6 or more views","date_of_service":"2026-05-10","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":"G0436","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"21630","name":"Radical resection sternum","description":"Radical resection of sternum","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1435.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4558","name":"Conductive gel or paste","description":"Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"75805","name":"Lymph vessel x-ray trunk","description":"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":884.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"13100","name":"Cmplx rpr trunk 1.1-2.5 cm","description":"Repair, complex, trunk; 1.1 cm to 2.5 cm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-10","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":"83901","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1810","name":"Adjust knee ext & flex dev","description":"Dynamic adjustable knee extension and flexion device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50650","name":"Removal of ureter","description":"Ureterectomy, with bladder cuff (separate procedure)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38300","name":"Drainage lymph node lesion","description":"Drainage of lymph node abscess or lymphadenitis; simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1776.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"82017","name":"Acylcarnitines quant","description":"Acylcarnitines; quantitative, each specimen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34825","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"85060","name":"Blood smear interpretation","description":"Blood smear, peripheral, interpretation by physician with written report","date_of_service":"2026-05-10","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":"E0236","name":"Pump for water circulating p","description":"Pump for water circulating pad","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-10","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":"25652","name":"Optx ulnar styloid fracture","description":"Open treatment of ulnar styloid fracture","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"50520","name":"Close kidney-skin fistula","description":"Closure of nephrocutaneous or pyelocutaneous fistula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2968.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"84484","name":"Assay of troponin quant","description":"Troponin, quantitative","date_of_service":"2026-05-10","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":"00222","name":"Anes icr px ecoag icr nrv","description":"Anesthesia for intracranial procedures; electrocoagulation of intracranial nerve","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","date_of_service":"2026-05-10","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":"76516","name":"Echo exam of eye","description":"Ophthalmic biometry by ultrasound echography, a-scan;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83900","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6246","name":"Hydrogel drg >16<=48 in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44391","name":"Colonoscopy for bleeding","description":"Colonoscopy through stoma; with control of bleeding, any method","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23491","name":"Reinforce shoulder bones","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; proximal humerus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1249.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3399.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2308","name":"Lens sphc trifocal 4.25-7/2.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1093.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62200","name":"Establish brain cavity shunt","description":"Ventriculocisternostomy, third ventricle;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59412","name":"Antepartum manipulation","description":"External cephalic version, with or without tocolysis","date_of_service":"2026-05-10","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":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78740","name":"Ureteral reflux study","description":"Ureteral reflux study (radiopharmaceutical voiding cystogram)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"28060","name":"Partial removal foot fascia","description":"Fasciectomy, plantar fascia; partial (separate procedure)","date_of_service":"2026-05-10","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":"34803","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"15786","name":"Abrasion lesion single","description":"Abrasion; single lesion (eg, keratosis, scar)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62290","name":"Njx px discography lumbar","description":"Injection procedure for discography, each level; lumbar","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"64581","name":"Opn impltj nea sacral nerve","description":"Open implantation of neurostimulator electrode array; sacral nerve (transforaminal placement)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":870.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2109","name":"Spherocylinder 4.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"42804","name":"Biopsy of upper nose/throat","description":"Biopsy; nasopharynx, visible lesion, simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"77046","name":"Mri breast c- unilateral","description":"Magnetic resonance imaging, breast, without contrast material; unilateral","date_of_service":"2026-05-10","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":"78725","name":"Kidney function study","description":"Kidney function study, non-imaging radioisotopic study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74445","name":"X-ray exam of penis","description":"Corpora cavernosography, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"15321","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2008.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55680","name":"Remove sperm pouch lesion","description":"Excision of mullerian duct cyst","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92610","name":"Evaluate swallowing function","description":"Evaluation of oral and pharyngeal swallowing function","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1854.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75968","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1054.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25405","name":"Repair/graft radius or ulna","description":"Repair of nonunion or malunion, radius or ulna; with autograft (includes obtaining graft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57700","name":"Revision of cervix","description":"Cerclage of uterine cervix, nonobstetrical","date_of_service":"2026-05-10","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":"94728","name":"Airwy resist by oscillometry","description":"Airway resistance by oscillometry","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":688.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":821.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5812","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"26600","name":"Treat metacarpal fracture","description":"Closed treatment of metacarpal fracture, single; without manipulation, each bone","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"55873","name":"Cryoablate prostate","description":"Cryosurgical ablation of the prostate (includes ultrasonic guidance and monitoring)","date_of_service":"2026-05-10","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":"76529","name":"Echo exam of eye","description":"Ophthalmic ultrasonic foreign body localization","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0560","name":"Humidifier supplemental w/ i","description":"Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery","date_of_service":"2026-05-10","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":"95866","name":"Needle emg hemidiaphragm","description":"Needle electromyography; hemidiaphragm","date_of_service":"2026-05-10","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":"88356","name":"Analysis nerve","description":"Morphometric analysis; nerve","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19100","name":"Bx breast percut w/o image","description":"Biopsy of breast; percutaneous, needle core, not using imaging guidance (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93235","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"L8510","name":"Voice amplifier","description":"Voice amplifier","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1372.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82784","name":"Assay iga/igd/igg/igm each","description":"Gammaglobulin (immunoglobulin); iga, igd, igg, igm, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B9006","name":"Parenteral infus pump statio","description":"Parenteral nutrition infusion pump, stationary","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"23120","name":"Claviculectomy partial","description":"Claviculectomy; partial","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"49420","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"75741","name":"Artery x-rays lung","description":"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"23332","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3561.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0509T","name":"Pattern erg w/i&r","description":"Electroretinography (erg) with interpretation and report, pattern (perg)","date_of_service":"2026-05-10","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":"50360","name":"Rnl altrnsplj w/o rcp nfrct","description":"Renal allotransplantation, implantation of graft; without recipient nephrectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2105.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92065","name":"Orthop traing pfrmd phys/qhp","description":"Orthoptic training; performed by a physician or other qualified health care professional","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"31512","name":"Removal of larynx lesion","description":"Laryngoscopy, indirect; with removal of lesion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"G0319","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"01140","name":"Anes ntrplvabdmnl amputation","description":"Anesthesia for interpelviabdominal (hindquarter) amputation","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"43305","name":"Repair esophagus and fistula","description":"Esophagoplasty (plastic repair or reconstruction), cervical approach; with repair of tracheoesophageal fistula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78466","name":"Heart infarct image","description":"Myocardial imaging, infarct avid, planar; qualitative or quantitative","date_of_service":"2026-05-10","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":"23412","name":"Repair rotator cuff chronic","description":"Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; chronic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1161.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L0976","name":"Lso full corset","description":"Lso, full corset","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65850","name":"Trabeculotomy ab externo","description":"Trabeculotomy ab externo","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1549.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27256","name":"Treat hip dislocation","description":"Treatment of spontaneous hip dislocation (developmental, including congenital or pathological), by abduction, splint or traction; without anesthesia, without manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70490","name":"Ct soft tissue neck w/o dye","description":"Computed tomography, soft tissue neck; without contrast material","date_of_service":"2026-05-10","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":"80198","name":"Assay of theophylline","description":"Theophylline","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6266","name":"Impreg gauze no h20/sal/yard","description":"Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1830","name":"Adjust toe ext & flex device","description":"Dynamic adjustable toe extension and flexion device, includes soft interface material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8002","name":"Brst prsth bra & bilat form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"50688","name":"Change of ureter tube/stent","description":"Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"15321","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00102","name":"Anes px plstc rpr cleft lip","description":"Anesthesia for procedures involving plastic repair of cleft lip","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33916","name":"Surgery of great vessel","description":"Pulmonary endarterectomy, with or without embolectomy, with cardiopulmonary bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"G0325","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"26545","name":"Reconstruct finger joint","description":"Reconstruction, collateral ligament, interphalangeal joint, single, including graft, each joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1455.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"G0202","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"00908","name":"Anes perineal prostatectomy","description":"Anesthesia for; perineal prostatectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2358","name":"Gr 34 nonsealed leadacid","description":"Power wheelchair accessory, group 34 non-sealed lead acid battery, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4225","name":"Sup/ext insulin inf pump syr","description":"Supplies for external insulin infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3011.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92235","name":"Fluorescein angrph mltiframe","description":"Fluorescein angiography (includes multiframe imaging) with interpretation and report, unilateral or bilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4556","name":"Electrodes, pair","description":"Electrodes, (e.g., apnea monitor), per pair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-10","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":"A4595","name":"Tens suppl 2 lead per month","description":"Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"90834","name":"Psytx w pt 45 minutes","description":"Psychotherapy, 45 minutes with patient","date_of_service":"2026-05-10","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":"43280","name":"Laparoscopy fundoplasty","description":"Laparoscopy, surgical, esophagogastric fundoplasty (eg, nissen, toupet procedures)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21026","name":"Excision of facial bone(s)","description":"Excision of bone (eg, for osteomyelitis or bone abscess); facial bone(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"80190","name":"Assay of procainamide","description":"Procainamide;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84442","name":"Assay of thyroid activity","description":"Thyroxine binding globulin (tbg)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1343.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KM"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0205","name":"Heat lamp with stand","description":"Heat lamp, with stand, includes bulb, or infrared element","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5712","name":"Knee-shin exo frict swg & st","description":"Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2565.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45381","name":"Colonoscopy submucous njx","description":"Colonoscopy, flexible; with directed submucosal injection(s), any substance","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2091.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89322","name":"Semen anal strict criteria","description":"Semen analysis; volume, count, motility, and differential using strict morphologic criteria (eg, kruger)","date_of_service":"2026-05-10","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":"28825","name":"Partial amputation of toe","description":"Amputation, toe; interphalangeal joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82634","name":"Deoxycortisol","description":"Deoxycortisol, 11-","date_of_service":"2026-05-10","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":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43760","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15757","name":"Free skin flap microvasc","description":"Free skin flap with microvascular anastomosis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1445.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26540","name":"Repair hand joint","description":"Repair of collateral ligament, metacarpophalangeal or interphalangeal joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":893.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2464.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J7674","name":"Methacholine chloride, neb","description":"Methacholine chloride administered as inhalation solution through a nebulizer, per 1 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"23040","name":"Arthrt gh jt expl/drg/rmv fb","description":"Arthrotomy, glenohumeral joint, including exploration, drainage, or removal of foreign body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":851.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6217","name":"Non-sterile gauze>16<=48 sq","description":"Gauze, non-impregnated, non-sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"76831","name":"Echo exam uterus","description":"Saline infusion sonohysterography (sis), including color flow doppler, when performed","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"77072","name":"Bone age studies","description":"Bone age studies","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28160","name":"Partial removal of toe","description":"Hemiphalangectomy or interphalangeal joint excision, toe, proximal end of phalanx, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1190","name":"Wheelchair amputee w/ leg re","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable elevating legrests","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2475.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69210","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen requiring instrumentation, unilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"58770","name":"Create new tubal opening","description":"Salpingostomy (salpingoneostomy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"71023","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9185","name":"Fludarabine phosphate inj","description":"Injection, fludarabine phosphate, 50 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":415.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2305","name":"Lens sphcy trifocal 4.0/4.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00 cylinder, per lens","date_of_service":"2026-05-10","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":"27025","name":"Fasciotomy hip/thigh any typ","description":"Fasciotomy, hip or thigh, any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":978.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["TC"]}],"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":"2026-05-10","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":"42806","name":"Biopsy of upper nose/throat","description":"Biopsy; nasopharynx, survey for unknown primary lesion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-10","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":"58820","name":"Drain ovary abscess open","description":"Drainage of ovarian abscess; vaginal approach, open","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"87270","name":"Chlamydia trachomatis ag if","description":"Infectious agent antigen detection by immunofluorescent technique; chlamydia trachomatis","date_of_service":"2026-05-10","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":"01756","name":"Anes opn/arthrs elbw rad px","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; radical procedures","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"68135","name":"Destruction les conjunctiva","description":"Destruction of lesion, conjunctiva","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"95903","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"76519","name":"Echo exam of eye","description":"Ophthalmic biometry by ultrasound echography, a-scan; with intraocular lens power calculation","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50236","name":"Removal of kidney & ureter","description":"Nephrectomy with total ureterectomy and bladder cuff; through separate incision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1606.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2430","name":"Knee jnt ratchet lock ea jnt","description":"Addition to knee joint, ratchet lock for active and progressive knee extension, each joint","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"15756","name":"Free myo/skin flap microvasc","description":"Free muscle or myocutaneous flap with microvascular anastomosis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33732","name":"Repair heart-vein defect","description":"Repair of cor triatriatum or supravalvular mitral ring by resection of left atrial membrane","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"40843","name":"Reconstruction of mouth","description":"Vestibuloplasty; posterior, bilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":953.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"43631","name":"Removal of stomach partial","description":"Gastrectomy, partial, distal; with gastroduodenostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1211.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76083","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1491.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":683.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-10","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":"01214","name":"Anes open px tot hip arthrp","description":"Anesthesia for open procedures involving hip joint; total hip arthroplasty","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"26060","name":"Incision of finger tendon","description":"Tenotomy, percutaneous, single, each digit","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2154.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69405","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33417","name":"Repair of aortic valve","description":"Aortoplasty (gusset) for supravalvular stenosis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1446.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28585","name":"Repair foot dislocation","description":"Open treatment of talotarsal joint dislocation, includes internal fixation, when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86001","name":"Allergen specific igg","description":"Allergen specific igg quantitative or semiquantitative, each allergen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KC"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65771","name":"Radial keratotomy","description":"Radial keratotomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94350","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","date_of_service":"2026-05-10","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":"75625","name":"Contrast exam abdominl aorta","description":"Aortography, abdominal, by serialography, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11451","name":"Exc skn hdrdnt ax complex","description":"Excision of skin and subcutaneous tissue for hidradenitis, axillary; with complex repair","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90845","name":"Psychoanalysis","description":"Psychoanalysis","date_of_service":"2026-05-10","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":"L5992","name":"Low prosth foot shell repl","description":"All lower extremity prosthesis, foot shell for modular foot/non-solid ankle cushion heel (sach) replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"0197T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"58559","name":"Hysteroscopy lysis","description":"Hysteroscopy, surgical; with lysis of intrauterine adhesions (any method)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","date_of_service":"2026-05-10","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":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-05-10","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":"29445","name":"Appl rigid tot cntc leg cast","description":"Application of rigid total contact leg cast","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":465.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"35538","name":"Art byp grft aortobi-iliac","description":"Bypass graft, with vein; aortobi-iliac","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"58752","name":"Revise ovarian tube(s)","description":"Tubouterine implantation","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","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":"54900","name":"Fusion of spermatic ducts","description":"Epididymovasostomy, anastomosis of epididymis to vas deferens; unilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":648.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57288","name":"Repair bladder defect","description":"Sling operation for stress incontinence (eg, fascia or synthetic)","date_of_service":"2026-05-10","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":"48500","name":"Surgery of pancreatic cyst","description":"Marsupialization of pancreatic cyst","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6950","name":"Above elbow switch control","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84460","name":"Alanine amino (alt) (sgpt)","description":"Transferase; alanine amino (alt) (sgpt)","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"30200","name":"Injection treatment of nose","description":"Injection into turbinate(s), therapeutic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2511","name":"Cntct toric prism ballast","description":"Contact lens, gas permeable, toric, prism ballast, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4360","name":"Pneumat walking boot pre cst","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-10","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":"36620","name":"Insertion catheter artery","description":"Arterial catheterization or cannulation for sampling, monitoring or transfusion (separate procedure); percutaneous","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4590","name":"Special casting material","description":"Special casting material (e.g., fiberglass)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44620","name":"Repair bowel opening","description":"Closure of enterostomy, large or small intestine;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":846.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"45820","name":"Repair rectourethral fistula","description":"Closure of rectourethral fistula;","date_of_service":"2026-05-10","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":"29075","name":"Appl cst elbw fngr short arm","description":"Application, cast; elbow to finger (short arm)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1435.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27441","name":"Revision of knee joint","description":"Arthroplasty, knee, tibial plateau; with debridement and partial synovectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":880.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2795","name":"Knee control full kneecap","description":"Addition to lower extremity orthosis, knee control, full kneecap","date_of_service":"2026-05-10","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":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2524","name":"Cntct lens hydrophil photoch","description":"Contact lens, hydrophilic, spherical, photochromic additive, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"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":"2026-05-10","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":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"15401","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J9310","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"67255","name":"Reinforce/graft eye wall","description":"Scleral reinforcement (separate procedure); with graft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93541","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"29915","name":"Hip arthro acetabuloplasty","description":"Arthroscopy, hip, surgical; with acetabuloplasty (ie, treatment of pincer lesion)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89320","name":"Semen anal vol/count/mot","description":"Semen analysis; volume, count, motility, and differential","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51575","name":"Removal of bladder & nodes","description":"Cystectomy, complete; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84150","name":"Assay of prostaglandin","description":"Prostaglandin, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86677","name":"Helicobacter pylori antibody","description":"Antibody; helicobacter pylori","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","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":"82950","name":"Glucose test","description":"Glucose; post glucose dose (includes glucose)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"59840","name":"Induced abortion d&c","description":"Induced abortion, by dilation and curettage","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59135","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"L5590","name":"Prep ak ischial laminated","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model","date_of_service":"2026-05-10","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":"L5400","name":"Postop dress & 1 cast chg bk","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"66700","name":"Destruction ciliary body","description":"Ciliary body destruction; diathermy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"62192","name":"Establish brain cavity shunt","description":"Creation of shunt; subarachnoid/subdural-peritoneal, -pleural, other terminus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1055.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":561.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"89325","name":"Sperm antibody test","description":"Sperm antibodies","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33534","name":"Cabg arterial two","description":"Coronary artery bypass, using arterial graft(s); 2 coronary arterial grafts","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1520","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"48180","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1695.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"69005","name":"Drg xtrnl ear absc/hem comp","description":"Drainage external ear, abscess or hematoma; complicated","date_of_service":"2026-05-10","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":"74235","name":"Remove esophagus obstruction","description":"Removal of foreign body(s), esophageal, with use of balloon catheter, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21343","name":"Open tx dprsd front sinus fx","description":"Open treatment of depressed frontal sinus fracture","date_of_service":"2026-05-10","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":"75552","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":671.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2102","name":"Singl visn sphere 7.12-20.00","description":"Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"11970","name":"Rplcmt tiss xpndr perm implt","description":"Replacement of tissue expander with permanent implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1920","name":"Afo sing upright w/ adjust s","description":"Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated","date_of_service":"2026-05-10","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":"35637","name":"Bpg aortoiliac","description":"Bypass graft, with other than vein; aortoiliac","date_of_service":"2026-05-10","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":"33516","name":"Cabg vein six or more","description":"Coronary artery bypass, vein only; 6 or more coronary venous grafts","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2354.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":850.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25001","name":"Incise flexor carpi radialis","description":"Incision, flexor tendon sheath, wrist (eg, flexor carpi radialis)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4425","name":"Ost pch drain for barrier fl","description":"Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each","date_of_service":"2026-05-10","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":"G0455","name":"Fecal microbiota prep instil","description":"Preparation with instillation of fecal microbiota by any method, including assessment of donor specimen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L3968","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61686","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; infratentorial, complex","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4382.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","date_of_service":"2026-05-10","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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"42650","name":"Dilation of salivary duct","description":"Dilation salivary duct","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0945","name":"Belt/harness extremity","description":"Extremity belt/harness","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50547","name":"Laparo removal donor kidney","description":"Laparoscopy, surgical; donor nephrectomy (including cold preservation), from living donor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1740.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41110","name":"Excision of tongue lesion","description":"Excision of lesion of tongue without closure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2102","name":"Singl visn sphere 7.12-20.00","description":"Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens","date_of_service":"2026-05-10","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":"69602","name":"Rev mstdc rslt mod rad mstdc","description":"Revision mastoidectomy; resulting in modified radical mastoidectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","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":"2026-05-10","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":"87562","name":"M.avium-intra dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria avium-intracellulare, quantification","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KC"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":604.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27158","name":"Revision of pelvis","description":"Osteotomy, pelvis, bilateral (eg, congenital malformation)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82731","name":"Assay of fetal fibronectin","description":"Fetal fibronectin, cervicovaginal secretions, semi-quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":587.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0585","name":"Nebulizer w/ compressor & he","description":"Nebulizer, with compressor and heater","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"20100","name":"Expl pentrg wound neck","description":"Exploration of penetrating wound (separate procedure); neck","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26477","name":"Tendon shortening","description":"Shortening of tendon, extensor, hand or finger, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74177","name":"Ct abd & pelvis w/contrast","description":"Computed tomography, abdomen and pelvis; with contrast material(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01472","name":"Anes rpr rpt achilles tendon","description":"Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; repair of ruptured achilles tendon, with or without graft","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61875","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75741","name":"Artery x-rays lung","description":"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":831.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32225","name":"Partial release of lung","description":"Decortication, pulmonary (separate procedure); partial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A4247","name":"Betadine/iodine swabs/wipes","description":"Betadine or iodine swabs/wipes, per box","date_of_service":"2026-05-10","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":"84203","name":"Test rbc protoporphyrin","description":"Protoporphyrin, rbc; screen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1195","name":"Wheelchair amputee heavy dut","description":"Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G0462","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"43261","name":"Endo cholangiopancreatograph","description":"Endoscopic retrograde cholangiopancreatography (ercp); with biopsy, single or multiple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"77263","name":"Ther radiology tx plng cplx","description":"Therapeutic radiology treatment planning; complex","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8678","name":"Ext sply implt neurostim","description":"Electrical stimulator supplies (external) for use with implantable neurostimulator, per month","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["AW"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93590","name":"Perq transcath cls mitral","description":"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device, mitral valve","date_of_service":"2026-05-10","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":"37180","name":"Revision of circulation","description":"Venous anastomosis, open; splenorenal, proximal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"71120","name":"X-ray exam breastbone 2/>vws","description":"Radiologic examination; sternum, minimum of 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":562.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6694","name":"Elbow socket ins use w/lock","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6212","name":"Foam drg <=16 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":784.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59510","name":"Cesarean delivery","description":"Routine obstetric care including antepartum care, cesarean delivery, and postpartum care","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64581","name":"Opn impltj nea sacral nerve","description":"Open implantation of neurostimulator electrode array; sacral nerve (transforaminal placement)","date_of_service":"2026-05-10","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":"15341","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-10","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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73115","name":"Contrast x-ray of wrist","description":"Radiologic examination, wrist, arthrography, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"B4220","name":"Parenteral supply kit premix","description":"Parenteral nutrition supply kit; premix, per day","date_of_service":"2026-05-10","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":"50590","name":"Fragmenting of kidney stone","description":"Lithotripsy, extracorporeal shock wave","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21268","name":"Revise eye sockets","description":"Orbital repositioning, periorbital osteotomies, unilateral, with bone grafts; combined intra- and extracranial approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2196.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3031","name":"Foot lamin/prepreg composite","description":"Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5600","name":"Hip disart sach laminat mold","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2440.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0457","name":"Tlso flex trnk sj-ss pre ots","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"54240","name":"Penile plethysmography","description":"Penile plethysmography","date_of_service":"2026-05-10","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":"78306","name":"Bone imaging whole body","description":"Bone and/or joint imaging; whole body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15650","name":"Transfer skin pedicle flap","description":"Transfer, intermediate, of any pedicle flap (eg, abdomen to wrist, walking tube), any location","date_of_service":"2026-05-10","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":"59841","name":"Induced abortion dilat&evac","description":"Induced abortion, by dilation and evacuation","date_of_service":"2026-05-10","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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-10","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":"L8659","name":"Interphalangeal joint repl","description":"Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"82668","name":"Assay of erythropoietin","description":"Erythropoietin","date_of_service":"2026-05-10","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":"95937","name":"Neuromuscular junction test","description":"Neuromuscular junction testing (repetitive stimulation, paired stimuli), each nerve, any 1 method","date_of_service":"2026-05-10","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":"A4619","name":"Face tent","description":"Face tent","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"28645","name":"Repair toe dislocation","description":"Open treatment of metatarsophalangeal joint dislocation, includes internal fixation, when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"69535","name":"Remove part of temporal bone","description":"Resection temporal bone, external approach","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-10","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":"95957","name":"Eeg digital analysis","description":"Digital analysis of electroencephalogram (eeg) (eg, for epileptic spike analysis)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35556","name":"Art byp grft fem-popliteal","description":"Bypass graft, with vein; femoral-popliteal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2184.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2772.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2560","name":"Phenobarbital sodium inj","description":"Injection, phenobarbital sodium, up to 120 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-05-10","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":"78593","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"95075","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1057.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51992","name":"Laparo sling operation","description":"Laparoscopy, surgical; sling operation for stress incontinence (eg, fascia or synthetic)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-10","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":"28294","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78201","name":"Liver imaging static only","description":"Liver imaging; static only","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"82286","name":"Assay of bradykinin","description":"Bradykinin","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"35201","name":"Repair blood vessel dir neck","description":"Repair blood vessel, direct; neck","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20103","name":"Expl pentrg wound extremity","description":"Exploration of penetrating wound (separate procedure); extremity","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"93532","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51880","name":"Repair of bladder opening","description":"Closure of cystostomy (separate procedure)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4412","name":"Ost pouch drain high output","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"20805","name":"Replant forearm complete","description":"Replantation, forearm (includes radius and ulna to radial carpal joint), complete amputation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2782.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44207","name":"L colectomy/coloproctostomy","description":"Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64761","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6382","name":"Postop dsg cast chg elb dis/","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"40830","name":"Repair mouth laceration","description":"Closure of laceration, vestibule of mouth; 2.5 cm or less","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75741","name":"Artery x-rays lung","description":"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28200","name":"Repair of foot tendon","description":"Repair, tendon, flexor, foot; primary or secondary, without free graft, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1610","name":"Ho frejka cov only pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"75564","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":"61684","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; infratentorial, simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3342.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"23900","name":"Interthoracoscplr amputation","description":"Interthoracoscapular amputation (forequarter)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1563.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"J2790","name":"Rho d immune globulin inj","description":"Injection, rho d immune globulin, human, full dose, 300 micrograms (1500 i.u.)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"E1195","name":"Wheelchair amputee heavy dut","description":"Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92140","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"35587","name":"Vein byp pop-tibl peroneal","description":"In-situ vein bypass; popliteal-tibial, peroneal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1203.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0605","name":"Repl batt lithium 4.5 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 4.5 volt, each","date_of_service":"2026-05-10","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":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29740","name":"Wedging of cast","description":"Wedging of cast (except clubfoot casts)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54235","name":"Njx corpora cavernosa rx agt","description":"Injection of corpora cavernosa with pharmacologic agent(s) (eg, papaverine, phentolamine)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75726","name":"Artery x-rays abdomen","description":"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35470","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3120.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50547","name":"Laparo removal donor kidney","description":"Laparoscopy, surgical; donor nephrectomy (including cold preservation), from living donor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1381.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72100","name":"X-ray exam l-s spine 2/3 vws","description":"Radiologic examination, spine, lumbosacral; 2 or 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J0740","name":"Cidofovir injection","description":"Injection, cidofovir, 375 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78013","name":"Thyroid imaging w/blood flow","description":"Thyroid imaging (including vascular flow, when performed);","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0461","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"A7020","name":"Interface, cough stim device","description":"Interface for cough stimulating device, includes all components, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3430","name":"Vitamin k phytonadione inj","description":"Injection, phytonadione (vitamin k), per 1 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6382","name":"Postop dsg cast chg elb dis/","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow","date_of_service":"2026-05-10","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":"29887","name":"Arthrs knee srg drlg od fixj","description":"Arthroscopy, knee, surgical; drilling for intact osteochondritis dissecans lesion with internal fixation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"A4422","name":"Ost pouch absorbent material","description":"Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67808","name":"Remove eyelid lesion(s)","description":"Excision of chalazion; under general anesthesia and/or requiring hospitalization, single or multiple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43415","name":"Repair esophagus wound","description":"Suture of esophageal wound or injury; transthoracic or transabdominal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1795.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"24134","name":"Sequestrectomy shft/dstl hum","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), shaft or distal humerus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78607","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":364.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6207","name":"Contact layer >16<= 48 sq in","description":"Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-10","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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-10","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":"75995","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55000","name":"Drainage of hydrocele","description":"Puncture aspiration of hydrocele, tunica vaginalis, with or without injection of medication","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"43341","name":"Fuse esophagus & intestine","description":"Esophagojejunostomy (without total gastrectomy); thoracic approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1511.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"49653","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":775.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74160","name":"Ct abdomen w/contrast","description":"Computed tomography, abdomen; with contrast material(s)","date_of_service":"2026-05-10","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":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","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":"0001A","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"36825","name":"Artery-vein autograft","description":"Creation of arteriovenous fistula by other than direct arteriovenous anastomosis (separate procedure); autogenous graft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"42330","name":"Removal of salivary stone","description":"Sialolithotomy; submandibular (submaxillary), sublingual or parotid, uncomplicated, intraoral","date_of_service":"2026-05-10","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":"A4418","name":"Ost pch clsd w/o bar w filtr","description":"Ostomy pouch, closed; without barrier attached, with filter (1 piece), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":660.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1563.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1434.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J9218","name":"Leuprolide acetate injeciton","description":"Leuprolide acetate, per 1 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"80156","name":"Assay carbamazepine total","description":"Carbamazepine; total","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92996","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"83951","name":"Oncoprotein dcp","description":"Oncoprotein; des-gamma-carboxy-prothrombin (dcp)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90935","name":"Hemodialysis one evaluation","description":"Hemodialysis procedure with single evaluation by a physician or other qualified health care professional","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3194.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92371","name":"Rpr&refit spct prsth aphakia","description":"Repair and refitting spectacles; spectacle prosthesis for aphakia","date_of_service":"2026-05-10","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":"E0158","name":"Walker leg extenders set of4","description":"Leg extensions for walker, per set of four (4)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1168.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85018","name":"Hemoglobin","description":"Blood count; hemoglobin (hgb)","date_of_service":"2026-05-10","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":"92545","name":"Oscillating tracking test","description":"Oscillating tracking test, with recording","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1025.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"45990","name":"Surg dx exam anorectal","description":"Anorectal exam, surgical, requiring anesthesia (general, spinal, or epidural), diagnostic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27428","name":"Reconstruction knee","description":"Ligamentous reconstruction (augmentation), knee; intra-articular (open)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8696","name":"Ext antenna phren nerve stim","description":"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"83885","name":"Assay of nickel","description":"Nickel","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51798","name":"Us urine capacity measure","description":"Measurement of post-voiding residual urine and/or bladder capacity by ultrasound, non-imaging","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"27465","name":"Shortening of thigh bone","description":"Osteoplasty, femur; shortening (excluding 64876)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1212.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"31750","name":"Tracheoplasty cervical","description":"Tracheoplasty; cervical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1033.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["TC"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99262","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6245","name":"Hydrogel drg <= 16 in w/bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"44186","name":"Lap jejunostomy","description":"Laparoscopy, surgical; jejunostomy (eg, for decompression or feeding)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":708.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"35656","name":"Bpg femoral-popliteal","description":"Bypass graft, with other than vein; femoral-popliteal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99364","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"78015","name":"Thyroid met imaging","description":"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4316","name":"Cath w/drainage 3-way","description":"Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83925","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24102","name":"Arthrt elbow w/synovectomy","description":"Arthrotomy, elbow; with synovectomy","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"72050","name":"X-ray exam neck spine 4/5vws","description":"Radiologic examination, spine, cervical; 4 or 5 views","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6572","name":"Grad com garment toe caps","description":"Gradient compression garment, toe caps, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77053","name":"X-ray of mammary duct","description":"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"L0472","name":"Tlso rigid frame hyperex pre","description":"Tlso, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coro","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-10","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":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-10","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":"29582","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1583.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30630","name":"Repair nasal septum defect","description":"Repair nasal septal perforations","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78006","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1076.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01772","name":"Anes art upr arm&elbw emblc","description":"Anesthesia for procedures on arteries of upper arm and elbow; embolectomy","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91200","name":"Liver elastography","description":"Liver elastography, mechanically induced shear wave (eg, vibration), without imaging, with interpretation and report","date_of_service":"2026-05-10","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":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"83498","name":"Asy hydroxyprogesterone 17-d","description":"Hydroxyprogesterone, 17-d","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45378","name":"Diagnostic colonoscopy","description":"Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"42440","name":"Excise submaxillary gland","description":"Excision of submandibular (submaxillary) gland","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["26"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"E1295","name":"Wheelchair heavy duty fixed","description":"Heavy duty wheelchair, fixed full length arms, elevating legrest","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","date_of_service":"2026-05-10","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":"63282","name":"Bx/exc idrl spine lesn lmbr","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, lumbar","date_of_service":"2026-05-10","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":"L3265","name":"Plastazote sandal each","description":"Plastazote sandal, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"B9002","name":"Enter nutr inf pump any type","description":"Enteral nutrition infusion pump, any type","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"E0744","name":"Neuromuscular stim for scoli","description":"Neuromuscular stimulator for scoliosis","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1533.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":703.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2046.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86780","name":"Treponema pallidum","description":"Antibody; treponema pallidum","date_of_service":"2026-05-10","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":"78710","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6531","name":"Compress stking bk30-40 surg","description":"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["AW"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"78111","name":"Plasma volume multiple","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings","date_of_service":"2026-05-10","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":"46080","name":"Sphnctrotmy anal div sphnctr","description":"Sphincterotomy, anal, division of sphincter (separate procedure)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","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":"24498","name":"Proph tx w/wo mthylmthcrylt","description":"Prophylactic treatment (nailing, pinning, plating or wiring), with or without methylmethacrylate, humeral shaft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1267.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"26080","name":"Explore/treat finger joint","description":"Arthrotomy, with exploration, drainage, or removal of loose or foreign body; interphalangeal joint, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"65855","name":"Trabeculoplasty laser surg","description":"Trabeculoplasty by laser surgery","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A5506","name":"Diabetic shoe w/off set heel","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1021.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7192","name":"Factor viii recombinant nos","description":"Factor viii (antihemophilic factor, recombinant) per i.u., not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00635","name":"Anes dx/ther lumbar pnxr","description":"Anesthesia for procedures in lumbar region; diagnostic or therapeutic lumbar puncture","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"92996","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0455","name":"Pump uninterrupted infusion","description":"Infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol)","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99328","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"45800","name":"Repair rect/bladder fistula","description":"Closure of rectovesical fistula;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2327.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1164.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":523.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":933.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85220","name":"Blooc clot factor v test","description":"Clotting; factor v (acg or proaccelerin), labile factor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1170F","name":"Fxnl status assessed","description":"Functional status assessed (coa) (ra)","date_of_service":"2026-05-10","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":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85385","name":"Fibrinogen antigen","description":"Fibrinogen; antigen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0359","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1065.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1171.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"84588","name":"Assay of vasopressin","description":"Vasopressin (antidiuretic hormone, adh)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72192","name":"Ct pelvis w/o dye","description":"Computed tomography, pelvis; without contrast material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"54438","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"92982","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33425","name":"Repair of mitral valve","description":"Valvuloplasty, mitral valve, with cardiopulmonary bypass;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1973.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"24370","name":"Revise reconst elbow joint","description":"Revision of total elbow arthroplasty, including allograft when performed; humeral or ulnar component","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1883.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"L7900","name":"Male vacuum erection system","description":"Male vacuum erection system","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0464","name":"Tlso 4mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, corona","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0515","name":"Sermorelin acetate injection","description":"Injection, sermorelin acetate, 1 microgram","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q4099","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":599.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68705","name":"Revise tear duct opening","description":"Correction of everted punctum, cautery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91122","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"90385","name":"Rh ig minidose im","description":"Rho(d) immune globulin (rhig), human, mini-dose, for intramuscular use","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0270","name":"Alprostadil for injection","description":"Injection, alprostadil, 1.25 mcg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"83001","name":"Assay of gonadotropin (fsh)","description":"Gonadotropin; follicle stimulating hormone (fsh)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1740.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0970","name":"Tlso corset front","description":"Tlso, corset front","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"42408","name":"Excision of salivary cyst","description":"Excision of sublingual salivary cyst (ranula)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"42225","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate; attachment pharyngeal flap","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1261.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63744","name":"Revision of spinal shunt","description":"Replacement, irrigation or revision of lumbosubarachnoid shunt","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","date_of_service":"2026-05-10","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":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","date_of_service":"2026-05-10","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":"76394","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A6211","name":"Foam drg > 48 sq in w/o brdr","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"95910","name":"Nrv cndj test 7-8 studies","description":"Nerve conduction studies; 7-8 studies","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"74260","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15839","name":"Exc excessive skn other area","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); other area","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3260","name":"Ambulatory surgical boot eac","description":"Surgical boot/shoe, each","date_of_service":"2026-05-10","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":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01829","name":"Anes dx arthroscopic px wrst","description":"Anesthesia for diagnostic arthroscopic procedures on the wrist","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9206","name":"Irinotecan injection","description":"Injection, irinotecan, 20 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","date_of_service":"2026-05-10","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":"78805","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"78469","name":"Heart infarct image (3d)","description":"Myocardial imaging, infarct avid, planar; tomographic spect with or without quantification","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"L3320","name":"Shoe lift elev heel/sole cor","description":"Lift, elevation, heel and sole, cork, per inch","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-10","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":"29835","name":"Elbow arthroscopy/surgery","description":"Arthroscopy, elbow, surgical; synovectomy, partial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"82384","name":"Assay three catecholamines","description":"Catecholamines; fractionated","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","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":"31205","name":"Removal of ethmoid sinus","description":"Ethmoidectomy; extranasal, total","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1026.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"63191","name":"Incise spine accessory nerve","description":"Laminectomy with section of spinal accessory nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3670","name":"So acro/clav can web pre ots","description":"Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":"L1810","name":"Ko elastic with joints","description":"Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1620","name":"Ho flex pavlik harns pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"L0462","name":"Tlso 3mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68705","name":"Revise tear duct opening","description":"Correction of everted punctum, cautery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6020","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"20957","name":"Mt bone graft microvasc","description":"Bone graft with microvascular anastomosis; metatarsal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2337.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"82127","name":"Amino acid single qual","description":"Amino acids; single, qualitative, each specimen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76870","name":"Us exam scrotum","description":"Ultrasound, scrotum and contents","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1170","name":"Whlchr ampu fxd arm leg rest","description":"Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7515","name":"Cyclosporine oral 25 mg","description":"Cyclosporine, oral, 25 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KN"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5000","name":"Sho insert w arch toe filler","description":"Partial foot, shoe insert with longitudinal arch, toe filler","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":882.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0735","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"63252","name":"Revise spine cord vsl thrlmb","description":"Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracolumbar","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3400.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","date_of_service":"2026-05-10","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":"00600","name":"Anes px crv spine&cord nos","description":"Anesthesia for procedures on cervical spine and cord; not otherwise specified","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"T4536","name":"Reusable pull-on any size","description":"Incontinence product, protective underwear/pull-on, reusable, any size, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"A6224","name":"Gauze > 48 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"83727","name":"Assay of lrh hormone","description":"Luteinizing releasing factor (lrh)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1506.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","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":"47460","name":"Incise bile duct sphincter","description":"Transduodenal sphincterotomy or sphincteroplasty, with or without transduodenal extraction of calculus (separate procedure)","date_of_service":"2026-05-10","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":"77416","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"54250","name":"Nctrnl pen tmscn&/rgdity tst","description":"Nocturnal penile tumescence and/or rigidity test","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50390","name":"Drainage of kidney lesion","description":"Aspiration and/or injection of renal cyst or pelvis by needle, percutaneous","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26449","name":"Release forearm/hand tendon","description":"Tenolysis, complex, extensor tendon, finger, including forearm, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1108.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-10","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":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"93602","name":"Intra-atrial recording","description":"Intra-atrial recording","date_of_service":"2026-05-10","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":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L5679","name":"Socket insert w/o lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82300","name":"Assay of cadmium","description":"Cadmium","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"47780","name":"Fuse bile ducts and bowel","description":"Anastomosis, roux-en-y, of extrahepatic biliary ducts and gastrointestinal tract","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2069.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58950","name":"Resect ovarian malignancy","description":"Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"J3246","name":"Tirofiban hcl","description":"Injection, tirofiban hcl, 0.25 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28636","name":"Treat toe dislocation","description":"Percutaneous skeletal fixation of metatarsophalangeal joint dislocation, with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-10","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":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0604","name":"Repl batt lithium 3.6 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22849","name":"Reinsert spinal fixation","description":"Reinsertion of spinal fixation device","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1147.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1437.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45116","name":"Partial removal of rectum","description":"Proctectomy, partial, with anastomosis; transsacral approach only (kraske type)","date_of_service":"2026-05-10","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":"61640","name":"Dilate ic vasospasm init","description":"Balloon dilatation of intracranial vasospasm, percutaneous; initial vessel","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6552","name":"Grad com stocking bk 30-40","description":"Gradient compression stocking, below knee, 30-40 mmhg, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6930","name":"Below elbow switch control","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3331.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76776","name":"Us exam k transpl w/doppler","description":"Ultrasound, transplanted kidney, real time and duplex doppler with image documentation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"34510","name":"Transposition of vein valve","description":"Venous valve transposition, any vein donor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33366","name":"Trcath replace aortic valve","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; transapical exposure (eg, left thoracotomy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82016","name":"Acylcarnitines qual","description":"Acylcarnitines; qualitative, each specimen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82710","name":"Fats/lipids feces quant","description":"Fat or lipids, feces; quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0738","name":"Portable gas oxygen system","description":"Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["QB","RR","QF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-05-10","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":"0145T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27740","name":"Repair of leg epiphyses","description":"Arrest, epiphyseal (epiphysiodesis), any method, combined, proximal and distal tibia and fibula;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":268.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"38700","name":"Removal of lymph nodes neck","description":"Suprahyoid lymphadenectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":680.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0880","name":"Trac stand free stand extrem","description":"Traction stand, free standing, extremity traction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"10120","name":"Inc&rmvl fb subq tiss smpl","description":"Incision and removal of foreign body, subcutaneous tissues; simple","date_of_service":"2026-05-10","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":"21260","name":"Revise eye sockets","description":"Periorbital osteotomies for orbital hypertelorism, with bone grafts; extracranial approach","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"J1931","name":"Laronidase injection","description":"Injection, laronidase, 0.1 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83898","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"76821","name":"Middle cerebral artery echo","description":"Doppler velocimetry, fetal; middle cerebral artery","date_of_service":"2026-05-10","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":"85530","name":"Heparin-protamine tolerance","description":"Heparin-protamine tolerance test","date_of_service":"2026-05-10","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":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR","","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J9340","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","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":"32405","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42509","name":"Parotid duct diversion","description":"Parotid duct diversion, bilateral (wilke type procedure); with excision of both submandibular glands","date_of_service":"2026-05-10","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":"86920","name":"Compatibility test spin","description":"Compatibility test each unit; immediate spin technique","date_of_service":"2026-05-10","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":"40500","name":"Partial excision of lip","description":"Vermilionectomy (lip shave), with mucosal advancement","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"53449","name":"Repair uro sphincter","description":"Repair of inflatable urethral/bladder neck sphincter, including pump, reservoir, and cuff","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"27381","name":"Repair/graft kneecap tendon","description":"Suture of infrapatellar tendon; secondary reconstruction, including fascial or tendon graft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KF"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01402","name":"Anes opn/arth tot kne arthrp","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; total knee arthroplasty","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"86759","name":"Rotavirus antibody","description":"Antibody; rotavirus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L2108","name":"Afo tib fx cast molded to pt","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35456","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83631","name":"Lactoferrin fecal (quant)","description":"Lactoferrin, fecal; quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"38500","name":"Biopsy/removal lymph nodes","description":"Biopsy or excision of lymph node(s); open, superficial","date_of_service":"2026-05-10","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":"E0635","name":"Patient lift electric","description":"Patient lift, electric with seat or sling","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3646.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":735.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92971","name":"Cardioassist external","description":"Cardioassist-method of circulatory assist; external","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38211","name":"Tumor cell deplete of harvst","description":"Transplant preparation of hematopoietic progenitor cells; tumor cell depletion","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"E0170","name":"Commode chair electric","description":"Commode chair with integrated seat lift mechanism, electric, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"95953","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":529.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4554","name":"Disposable underpads","description":"Disposable underpads, all sizes","date_of_service":"2026-05-10","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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-10","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":"84488","name":"Test feces for trypsin","description":"Trypsin; feces, qualitative","date_of_service":"2026-05-10","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":"L5590","name":"Prep ak ischial laminated","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94681","name":"O2 uptk co2 outp % o2 xtrc","description":"Oxygen uptake, expired gas analysis; including co2 output, percentage oxygen extracted","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83892","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"67318","name":"Revise eye muscle(s)","description":"Strabismus surgery, any procedure, superior oblique muscle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52265","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with dilation of bladder for interstitial cystitis; local anesthesia","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"32663","name":"Thoracoscopy w/lobectomy","description":"Thoracoscopy, surgical; with lobectomy (single lobe)","date_of_service":"2026-05-10","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":"50620","name":"Removal of ureter stone","description":"Ureterolithotomy; middle one-third of ureter","date_of_service":"2026-05-10","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":"88161","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; preparation, screening and interpretation","date_of_service":"2026-05-10","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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3102.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"30117","name":"Removal of intranasal lesion","description":"Excision or destruction (eg, laser), intranasal lesion; internal approach","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5814","name":"Endo knee-shin hydral swg ph","description":"Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63185","name":"Incise spine nrv half segmnt","description":"Laminectomy with rhizotomy; 1 or 2 segments","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1171.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-10","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":"J0133","name":"Acyclovir injection","description":"Injection, acyclovir, 5 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"27705","name":"Osteotomy tibia","description":"Osteotomy; tibia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":925.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37145","name":"Revision of circulation","description":"Venous anastomosis, open; renoportal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1725.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1193.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"94450","name":"Breathing response hypoxia","description":"Breathing response to hypoxia (hypoxia response curve)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"27176","name":"Treat slipped epiphysis","description":"Treatment of slipped femoral epiphysis; by single or multiple pinning, in situ","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1444.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00800","name":"Anes px lwr ant abdl wal nos","description":"Anesthesia for procedures on lower anterior abdominal wall; not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":"73562","name":"X-ray exam of knee 3","description":"Radiologic examination, knee; 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"16000","name":"Initial treatment of burn(s)","description":"Initial treatment, first degree burn, when no more than local treatment is required","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"39220","name":"Resect mediastinal tumor","description":"Resection of mediastinal tumor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1308.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["KE","NU"]}],"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":"2026-05-10","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":"87450","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98926","name":"Osteopath manj 3-4 regions","description":"Osteopathic manipulative treatment (omt); 3-4 body regions involved","date_of_service":"2026-05-10","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":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6310","name":"Shoulder passive restor comp","description":"Shoulder disarticulation, passive restoration (complete prosthesis)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4630","name":"Repl bat t.e.n.s. own by pt","description":"Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"32609","name":"Thoracoscopy w/bx pleura","description":"Thoracoscopy; with biopsy(ies) of pleura","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"56625","name":"Vulvectomy simple complete","description":"Vulvectomy simple; complete","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":659.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33694","name":"Cmp rpr tof wo plm atrs ptch","description":"Complete repair tetralogy of fallot without pulmonary atresia; with transannular patch","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76775","name":"Us exam abdo back wall lim","description":"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited","date_of_service":"2026-05-10","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":"A5500","name":"Diab shoe for density insert","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"36455","name":"Bld exchange truj oth thn nb","description":"Exchange transfusion, blood; other than newborn","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":345.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1767.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74182","name":"Mri abdomen w/contrast","description":"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"31287","name":"Nasal/sinus endoscopy surg","description":"Nasal/sinus endoscopy, surgical, with sphenoidotomy;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1161.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4022","name":"Cast sup sht arm splint fbrg","description":"Cast supplies, short arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":815.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"15837","name":"Exc excsv skin forearm/hand","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); forearm or hand","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":771.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82045","name":"Albumin ischemia modified","description":"Albumin; ischemia modified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1108.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":488.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71120","name":"X-ray exam breastbone 2/>vws","description":"Radiologic examination; sternum, minimum of 2 views","date_of_service":"2026-05-10","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":"91034","name":"Gastroesophageal reflux test","description":"Esophagus, gastroesophageal reflux test; with nasal catheter ph electrode(s) placement, recording, analysis and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42820","name":"Remove tonsils and adenoids","description":"Tonsillectomy and adenoidectomy; younger than age 12","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S8270","name":"Enuresis alarm","description":"Enuresis alarm, using auditory buzzer and/or vibration device","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33803","name":"Div aberrant vsl w/reanast","description":"Division of aberrant vessel (vascular ring); with reanastomosis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"41115","name":"Excision of tongue fold","description":"Excision of lingual frenum (frenectomy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L0626","name":"Lo sag rig pnl stays pre cst","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78291","name":"Pertl-ven shunt patency test","description":"Peritoneal-venous shunt patency test (eg, for leveen, denver shunt)","date_of_service":"2026-05-10","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":"31605","name":"Emer tracheostomy cthyr mem","description":"Tracheostomy, emergency procedure; cricothyroid membrane","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"85370","name":"Fibrinogen test","description":"Fibrin(ogen) degradation (split) products (fdp) (fsp); quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G0462","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"78140","name":"Red cell sequestration","description":"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic)","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"92975","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":402.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KL","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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"33675","name":"Close mult vsd","description":"Closure of multiple ventricular septal defects;","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":428.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"27428","name":"Reconstruction knee","description":"Ligamentous reconstruction (augmentation), knee; intra-articular (open)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1261.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"85635","name":"Reptilase test","description":"Reptilase test","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94450","name":"Breathing response hypoxia","description":"Breathing response to hypoxia (hypoxia response curve)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1036","name":"Patient transfer system >300","description":"Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"64712","name":"Revision of sciatic nerve","description":"Neuroplasty, major peripheral nerve, arm or leg, open; sciatic nerve","date_of_service":"2026-05-10","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":"48510","name":"Drain pancreatic pseudocyst","description":"External drainage, pseudocyst of pancreas, open","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76870","name":"Us exam scrotum","description":"Ultrasound, scrotum and contents","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"27097","name":"Revision of hip tendon","description":"Release or recession, hamstring, proximal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"29800","name":"Jaw arthroscopy/surgery","description":"Arthroscopy, temporomandibular joint, diagnostic, with or without synovial biopsy (separate procedure)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"84138","name":"Assay of pregnanetriol","description":"Pregnanetriol","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"G2061","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"77011","name":"Ct scan for localization","description":"Computed tomography guidance for stereotactic localization","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"57280","name":"Suspension of vagina","description":"Colpopexy, abdominal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1068.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93304","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study","date_of_service":"2026-05-10","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":"01844","name":"Anes vasc shunt/shunt revj","description":"Anesthesia for vascular shunt, or shunt revision, any type (eg, dialysis)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"28475","name":"Cltx metatarsal fx w/mnpj ea","description":"Closed treatment of metatarsal fracture; with manipulation, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73050","name":"X-ray exam of shoulders","description":"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction","date_of_service":"2026-05-10","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":"20200","name":"Muscle biopsy superficial","description":"Biopsy, muscle; superficial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94680","name":"O2 uptk rst&xers dir simple","description":"Oxygen uptake, expired gas analysis; rest and exercise, direct, simple","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27345","name":"Removal of knee cyst","description":"Excision of synovial cyst of popliteal space (eg, bakers cyst)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":574.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","date_of_service":"2026-05-10","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":"G6017","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2484.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1003.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"29889","name":"Arthrs aid pcl rpr/agmntj","description":"Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1422.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"J0275","name":"Alprostadil urethral suppos","description":"Alprostadil urethral suppository (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3010","name":"Foot longitudinal arch suppo","description":"Foot, insert, removable, molded to patient model, longitudinal arch support, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35606","name":"Bpg carotid-subclavian","description":"Bypass graft, with other than vein; carotid-subclavian","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1473.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"L1843","name":"Ko single upright pre cst","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":752.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45111","name":"Partial removal of rectum","description":"Proctectomy; partial resection of rectum, transabdominal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"92504","name":"Ear microscopy examination","description":"Binocular microscopy (separate diagnostic procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"96422","name":"Chemo ia infusion up to 1 hr","description":"Chemotherapy administration, intra-arterial; infusion technique, up to 1 hour","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61105","name":"Tdh sdrl/ventr pnxr","description":"Twist drill hole for subdural or ventricular puncture","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":481.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":875.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5595","name":"Hip disartic sach thermopls","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2205.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1215.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":966.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"00176","name":"Anes intraoral px rad surg","description":"Anesthesia for intraoral procedures, including biopsy; radical surgery","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96567","name":"Pdt dstr prmlg les skn","description":"Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitive drug(s), per day","date_of_service":"2026-05-10","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":"77321","name":"Special teletx port plan","description":"Special teletherapy port plan, particles, hemibody, total body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01916","name":"Anes dx arteriography/vngrph","description":"Anesthesia for diagnostic arteriography/venography","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50592","name":"Perc rf ablate renal tumor","description":"Ablation, 1 or more renal tumor(s), percutaneous, unilateral, radiofrequency","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9214","name":"Interferon alfa-2b inj","description":"Injection, interferon, alfa-2b, recombinant, 1 million units","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44153","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2154.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1041.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74260","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"V2204","name":"Lens sphcy bifocal 4.00d/2.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"36469","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"34800","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99332","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1223","name":"Wheelchair spec size w foot","description":"Wheelchair with detachable arms, footrests","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"01654","name":"Anes art sho&ax bypass grf","description":"Anesthesia for procedures on arteries of shoulder and axilla; bypass graft","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1108.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J0395","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1583.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-10","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":"27893","name":"Decompression of leg","description":"Decompression fasciotomy, leg; posterior compartment(s) only, with debridement of nonviable muscle and/or nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90675","name":"Rabies vaccine im","description":"Rabies vaccine, for intramuscular use","date_of_service":"2026-05-10","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":115.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J1056","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"30465","name":"Repair nasal stenosis","description":"Repair of nasal vestibular stenosis (eg, spreader grafting, lateral nasal wall reconstruction)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90827","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0498T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"55060","name":"Repair of hydrocele","description":"Repair of tunica vaginalis hydrocele (bottle type)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75840","name":"Vein x-ray adrenal gland","description":"Venography, adrenal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":"G0308","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"64719","name":"Revise ulnar nerve at wrist","description":"Neuroplasty and/or transposition; ulnar nerve at wrist","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"35491","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"21550","name":"Biopsy of neck/chest","description":"Biopsy, soft tissue of neck or thorax","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"68330","name":"Revise eyelid lining","description":"Repair of symblepharon; conjunctivoplasty, without graft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83003","name":"Assay growth hormone (hgh)","description":"Growth hormone, human (hgh) (somatotropin)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1110","name":"Wheelchair semi-recl detach","description":"Semi-reclining wheelchair, detachable arms (desk or full length) elevating leg rest","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86612","name":"Blastomyces antibody","description":"Antibody; blastomyces","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"50593","name":"Perc cryo ablate renal tum","description":"Ablation, renal tumor(s), unilateral, percutaneous, cryotherapy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75992","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52614","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":467.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":962.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"67820","name":"Revise eyelashes","description":"Correction of trichiasis; epilation, by forceps only","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L6694","name":"Elbow socket ins use w/lock","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","date_of_service":"2026-05-10","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":"A5501","name":"Diabetic custom molded shoe","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patients foot (custom molded shoe), per shoe","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"73560","name":"X-ray exam of knee 1 or 2","description":"Radiologic examination, knee; 1 or 2 views","date_of_service":"2026-05-10","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":"46735","name":"Construction of absent anus","description":"Repair of high imperforate anus without fistula; combined transabdominal and sacroperineal approaches","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1901.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"32851","name":"Lung transplant single","description":"Lung transplant, single; without cardiopulmonary bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2403.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51840","name":"Attach bladder/urethra","description":"Anterior vesicourethropexy, or urethropexy (eg, marshall-marchetti-krantz, burch); simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63267","name":"Excise intrspinl lesion lmbr","description":"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; lumbar","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1539.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"73085","name":"Contrast x-ray of elbow","description":"Radiologic examination, elbow, arthrography, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2975.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15852","name":"Dressing change not for burn","description":"Dressing change (for other than burns) under anesthesia (other than local)","date_of_service":"2026-05-10","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":"78300","name":"Bone imaging limited area","description":"Bone and/or joint imaging; limited area","date_of_service":"2026-05-10","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":"83719","name":"Assay of blood lipoprotein","description":"Lipoprotein, direct measurement; vldl cholesterol","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61680","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; supratentorial, simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2582.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25110","name":"Remove wrist tendon lesion","description":"Excision, lesion of tendon sheath, forearm and/or wrist","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3281.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37160","name":"Revision of circulation","description":"Venous anastomosis, open; caval-mesenteric","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1498.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33732","name":"Repair heart-vein defect","description":"Repair of cor triatriatum or supravalvular mitral ring by resection of left atrial membrane","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2017.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J3365","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69745","name":"Repair facial nerve","description":"Suture facial nerve, intratemporal, with or without graft or decompression; including medial to geniculate ganglion","date_of_service":"2026-05-10","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":"37660","name":"Ligation common iliac vein","description":"Ligation of common iliac vein","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1156.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0698","name":"Cefotaxime sodium injection","description":"Injection, cefotaxime sodium, per gm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"91034","name":"Gastroesophageal reflux test","description":"Esophagus, gastroesophageal reflux test; with nasal catheter ph electrode(s) placement, recording, analysis and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55175","name":"Revision of scrotum","description":"Scrotoplasty; simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47563","name":"Laparo cholecystectomy/graph","description":"Laparoscopy, surgical; cholecystectomy with cholangiography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19302","name":"P-mastectomy w/ln removal","description":"Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy); with axillary lymphadenectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":604.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63170","name":"Incise spinal cord tract(s)","description":"Laminectomy with myelotomy (eg, bischof or drez type), cervical, thoracic, or thoracolumbar","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1452.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90829","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"72132","name":"Ct lumbar spine w/dye","description":"Computed tomography, lumbar spine; with contrast material","date_of_service":"2026-05-10","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":"J7682","name":"Tobramycin non-comp unit","description":"Tobramycin, inhalation solution, fda-approved final product, non-compounded, unit dose form, administered through dme, per 300 milligrams","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93555","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00796","name":"Anes iper upr abd lvr trnspl","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; liver transplant (recipient)","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87185","name":"Sc std enzyme detcj per nzm","description":"Susceptibility studies, antimicrobial agent; enzyme detection (eg, beta lactamase), per enzyme","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82438","name":"Assay other fluid chlorides","description":"Chloride; other source","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":553.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88283","name":"Chromosome banding study","description":"Chromosome analysis; additional specialized banding technique (eg, nor, c-banding)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52647","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86334","name":"Immunofix e-phoresis serum","description":"Immunofixation electrophoresis; serum","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"85445","name":"Heinz bodies induced","description":"Heinz bodies; induced, acetyl phenylhydrazine","date_of_service":"2026-05-10","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":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87103","name":"Blood fungus culture","description":"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; blood","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5640","name":"Knee disarticulat leather so","description":"Addition to lower extremity, knee disarticulation, leather socket","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"53621","name":"Dilate urethra stricture","description":"Dilation of urethral stricture by passage of filiform and follower, male; subsequent","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"90823","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57130","name":"Excision vaginal septum","description":"Excision of vaginal septum","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":802.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1813.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"78740","name":"Ureteral reflux study","description":"Ureteral reflux study (radiopharmaceutical voiding cystogram)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"45000","name":"Drainage of pelvic abscess","description":"Transrectal drainage of pelvic abscess","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57120","name":"Colpocleisis le fort type","description":"Colpocleisis (le fort type)","date_of_service":"2026-05-10","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":"86900","name":"Blood typing serologic abo","description":"Blood typing, serologic; abo","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95956","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"21632","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41120","name":"Partial removal of tongue","description":"Glossectomy; less than one-half tongue","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76950","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","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":"35558","name":"Art byp grft fem-femoral","description":"Bypass graft, with vein; femoral-femoral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70551","name":"Mri brain stem w/o dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71040","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"86384","name":"Nitroblue tetrazolium dye","description":"Nitroblue tetrazolium dye test (ntd)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2561.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28725","name":"Arthrodesis subtalar","description":"Arthrodesis; subtalar","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q9956","name":"Inj octafluoropropane mic,ml","description":"Injection, octafluoropropane microspheres, per ml","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84234","name":"Assay of progesterone","description":"Receptor assay; progesterone","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00812","name":"Anes lwr intst scr colsc","description":"Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; screening colonoscopy","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"78003","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"39000","name":"Exploration of chest","description":"Mediastinotomy with exploration, drainage, removal of foreign body, or biopsy; cervical approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"69450","name":"Eardrum revision","description":"Tympanolysis, transcanal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73520","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0172T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"90819","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1371.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4234","name":"J-cell batt for glucose mon","description":"Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-10","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":"27686","name":"Revise lower leg tendons","description":"Lengthening or shortening of tendon, leg or ankle; multiple tendons (through same incision), each","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3924","name":"Hfo without joints pre ots","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0762","name":"Trans elec jt stim dev sys","description":"Transcutaneous electrical joint stimulation device system, includes all accessories","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"V2501","name":"Cntct lens pmma-toric/prism","description":"Contact lens, pmma, toric or prism ballast, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"74355","name":"X-ray guide intestinal tube","description":"Percutaneous placement of enteroclysis tube, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"45114","name":"Partial removal of rectum","description":"Proctectomy, partial, with anastomosis; abdominal and transsacral approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1841.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3908","name":"Who cock-up nonmolde pre ots","description":"Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"64405","name":"Njx aa&/strd gr ocpl nrv","description":"Injection(s), anesthetic agent(s) and/or steroid; greater occipital nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19084","name":"Bx breast add lesion us imag","description":"Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; each additional lesion, including ultrasound guidance (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"65730","name":"Corneal transplant","description":"Keratoplasty (corneal transplant); penetrating (except in aphakia or pseudophakia)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1195.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76001","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25442","name":"Arthrp w/prostc dstl ulna","description":"Arthroplasty with prosthetic replacement; distal ulna","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":964.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88239","name":"Tissue culture tumor","description":"Tissue culture for neoplastic disorders; solid tumor","date_of_service":"2026-05-10","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":"77022","name":"Mri gdn parnchyma tiss abltj","description":"Magnetic resonance imaging guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29884","name":"Arthrs knee surg lysis ads","description":"Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure)","date_of_service":"2026-05-10","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":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"86617","name":"Lyme disease antibody","description":"Antibody; borrelia burgdorferi (lyme disease) confirmatory test (eg, western blot or immunoblot)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27645","name":"Resect tibia tumor","description":"Radical resection of tumor; tibia","date_of_service":"2026-05-10","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":"95955","name":"Eeg during surgery","description":"Electroencephalogram (eeg) during nonintracranial surgery (eg, carotid surgery)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0461","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-10","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":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"49655","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28293","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2755","name":"Carbon graphite lamination","description":"Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"32660","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"25111","name":"Remove wrist tendon lesion","description":"Excision of ganglion, wrist (dorsal or volar); primary","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":771.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50860","name":"Transplant ureter to skin","description":"Ureterostomy, transplantation of ureter to skin","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67908","name":"Repair eyelid defect","description":"Repair of blepharoptosis; conjunctivo-tarso-mullers muscle-levator resection (eg, fasanella-servat type)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35460","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1237","name":"Rgd ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, rigid, adjustable, without seating system","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"92546","name":"Sinusoidal rotational test","description":"Sinusoidal vertical axis rotational testing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"V2313","name":"Lens sphc trifo 7.25-12/4.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"73130","name":"X-ray exam of hand","description":"Radiologic examination, hand; minimum of 3 views","date_of_service":"2026-05-10","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":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1680.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1632.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40845","name":"Reconstruction of mouth","description":"Vestibuloplasty; complex (including ridge extension, muscle repositioning)","date_of_service":"2026-05-10","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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93304","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24136","name":"Sequestrectomy radial h/n","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), radial head or neck","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92625","name":"Tinnitus assessment","description":"Assessment of tinnitus (includes pitch, loudness matching, and masking)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29830","name":"Elbow arthroscopy","description":"Arthroscopy, elbow, diagnostic, with or without synovial biopsy (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"50394","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"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":"2026-05-10","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":"27675","name":"Repair lower leg tendons","description":"Repair, dislocating peroneal tendons; without fibular osteotomy","date_of_service":"2026-05-10","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":"11980","name":"Implant hormone pellet(s)","description":"Subcutaneous hormone pellet implantation (implantation of estradiol and/or testosterone pellets beneath the skin)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"72072","name":"X-ray exam thorac spine 3vws","description":"Radiologic examination, spine; thoracic, 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"64862","name":"Repair of low back nerves","description":"Suture of; lumbar plexus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1167.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23040","name":"Arthrt gh jt expl/drg/rmv fb","description":"Arthrotomy, glenohumeral joint, including exploration, drainage, or removal of foreign body","date_of_service":"2026-05-10","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":"44141","name":"Partial removal of colon","description":"Colectomy, partial; with skin level cecostomy or colostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1432.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28306","name":"Incision of metatarsal","description":"Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; first metatarsal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35190","name":"Repair acq av fistula xtr","description":"Repair, acquired or traumatic arteriovenous fistula; extremities","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-05-10","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":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"73564","name":"X-ray exam knee 4 or more","description":"Radiologic examination, knee; complete, 4 or more views","date_of_service":"2026-05-10","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":"25310","name":"Transplant forearm tendon","description":"Tendon transplantation or transfer, flexor or extensor, forearm and/or wrist, single; each tendon","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"31420","name":"Epiglottidectomy","description":"Epiglottidectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54440","name":"Repair of penis","description":"Plastic operation of penis for injury","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":754.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36100","name":"Establish access to artery","description":"Introduction of needle or intracatheter, carotid or vertebral artery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0416","name":"Prostate biopsy, any mthd","description":"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00160","name":"Anes px nose&sinus nos","description":"Anesthesia for procedures on nose and accessory sinuses; not otherwise specified","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0230","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"74176","name":"Ct abd & pelvis w/o contrast","description":"Computed tomography, abdomen and pelvis; without contrast material","date_of_service":"2026-05-10","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":"Q0177","name":"Hydroxyzine pamoate 25mg","description":"Hydroxyzine pamoate, 25 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1625.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"66605","name":"Removal of iris","description":"Iridectomy, with corneoscleral or corneal section; with cyclectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82670","name":"Assay of total estradiol","description":"Estradiol; total","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1751","name":"Cath, inf, per/cent/midline","description":"Catheter, infusion, inserted peripherally, centrally or midline (other than hemodialysis)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4630","name":"Repl bat t.e.n.s. own by pt","description":"Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3011.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28715","name":"Arthrodesis triple","description":"Arthrodesis; triple","date_of_service":"2026-05-10","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":"94260","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"49560","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"L5672","name":"Bk removable medial brim sus","description":"Addition to lower extremity, below knee, removable medial brim suspension","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.16,"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":"27734","name":"Repair lower leg epiphyses","description":"Arrest, epiphyseal (epiphysiodesis), open; distal tibia and fibula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45112","name":"Removal of rectum","description":"Proctectomy, combined abdominoperineal, pull-through procedure (eg, colo-anal anastomosis)","date_of_service":"2026-05-10","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":"29824","name":"Sho arthrs srg dstl claviclc","description":"Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface (mumford procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1843","name":"Ko single upright pre cst","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57284","name":"Repair paravag defect open","description":"Paravaginal defect repair (including repair of cystocele, if performed); open abdominal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36625","name":"Insertion catheter artery","description":"Arterial catheterization or cannulation for sampling, monitoring or transfusion (separate procedure); cutdown","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"87185","name":"Sc std enzyme detcj per nzm","description":"Susceptibility studies, antimicrobial agent; enzyme detection (eg, beta lactamase), per enzyme","date_of_service":"2026-05-10","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":"58558","name":"Hysteroscopy biopsy","description":"Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without d & c","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":868.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":"28490","name":"Treat big toe fracture","description":"Closed treatment of fracture great toe, phalanx or phalanges; without manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q9950","name":"Inj sulf hexa lipid microsph","description":"Injection, sulfur hexafluoride lipid microspheres, per ml","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84402","name":"Assay of free testosterone","description":"Testosterone; free","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"67005","name":"Partial removal of eye fluid","description":"Removal of vitreous, anterior approach (open sky technique or limbal incision); partial removal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":480.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1476.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0495","name":"Charger elec/combo vad, rep","description":"Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67400","name":"Explore/biopsy eye socket","description":"Orbitotomy without bone flap (frontal or transconjunctival approach); for exploration, with or without biopsy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"80196","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1270","name":"Wheelchair lightweight leg r","description":"Lightweight wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50389","name":"Remove renal tube w/fluoro","description":"Removal of nephrostomy tube, requiring fluoroscopic guidance (eg, with concurrent indwelling ureteral stent)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2020","name":"Kafo dbl solid stirrup band/","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar ak orthosis), custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"78271","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"39545","name":"Revision of diaphragm","description":"Imbrication of diaphragm for eventration, transthoracic or transabdominal, paralytic or nonparalytic","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27328","name":"Exc thigh/knee tum deep <5cm","description":"Excision, tumor, soft tissue of thigh or knee area, subfascial (eg, intramuscular); less than 5 cm","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2151.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19125","name":"Excision breast lesion","description":"Excision of breast lesion identified by preoperative placement of radiological marker, open; single lesion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","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":"68328","name":"Revise/graft eyelid lining","description":"Conjunctivoplasty, reconstruction cul-de-sac; with buccal mucous membrane graft (includes obtaining graft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3666.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49560","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-05-10","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":"30120","name":"Revision of nose","description":"Excision or surgical planing of skin of nose for rhinophyma","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"29884","name":"Arthrs knee surg lysis ads","description":"Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-05-10","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":"15736","name":"Muscle-skin graft arm","description":"Muscle, myocutaneous, or fasciocutaneous flap; upper extremity","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1352.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"27818","name":"Treatment of ankle fracture","description":"Closed treatment of trimalleolar ankle fracture; with manipulation","date_of_service":"2026-05-10","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":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66160","name":"Glaucoma surgery","description":"Fistulization of sclera for glaucoma; sclerectomy with punch or scissors, with iridectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0027","name":"Semen analysis","description":"Semen analysis; presence and/or motility of sperm excluding huhner","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"88147","name":"Cytopath c/v automated","description":"Cytopathology smears, cervical or vaginal; screening by automated system under physician supervision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0490","name":"Tlso rigid plastic pre one","description":"Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, res","date_of_service":"2026-05-10","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":"71111","name":"X-ray exam ribs/chest4/> vws","description":"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":321.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"55705","name":"Bx prst8 any approach nonimg","description":"Biopsy, prostate, any approach, nonimaging-guided","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92981","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":683.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78650","name":"Csf leakage imaging","description":"Cerebrospinal fluid leakage detection and localization","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27295","name":"Amputation of leg at hip","description":"Disarticulation of hip","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1485.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"72190","name":"X-ray exam of pelvis","description":"Radiologic examination, pelvis; complete, minimum of 3 views","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"93890","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83068","name":"Hemoglobin unstable screen","description":"Hemoglobin; unstable, screen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78700","name":"Kidney imaging morphol","description":"Kidney imaging morphology;","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6253","name":"Absorpt drg > 48 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21031","name":"Remove exostosis mandible","description":"Excision of torus mandibularis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80158","name":"Drug assay cyclosporine","description":"Cyclosporine","date_of_service":"2026-05-10","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":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38760","name":"Remove groin lymph nodes","description":"Inguinofemoral lymphadenectomy, superficial, including cloquets node (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"47000","name":"Needle biopsy of liver perq","description":"Biopsy of liver, needle; percutaneous","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28210","name":"Repair/graft of foot tendon","description":"Repair, tendon, extensor, foot; secondary with free graft, each tendon (includes obtaining graft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":503.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E1228","name":"Wheelchair spec sz spec ht b","description":"Special back height for wheelchair","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73510","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"35663","name":"Bpg ilioiliac","description":"Bypass graft, with other than vein; ilioiliac","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1567.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"43453","name":"Dilate esophagus","description":"Dilation of esophagus, over guide wire","date_of_service":"2026-05-10","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":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"67343","name":"Release eye tissue","description":"Release of extensive scar tissue without detaching extraocular muscle (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":632.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78205","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"L8613","name":"Ossicular implant","description":"Ossicula implant","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5570","name":"Prep ak ischial direct form","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1911.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77057","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"84106","name":"Test for porphobilinogen","description":"Porphobilinogen, urine; qualitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"86922","name":"Compatibility test antiglob","description":"Compatibility test each unit; antiglobulin technique","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"V2700","name":"Balance lens","description":"Balance lens, per lens","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":625.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6707","name":"Term dev mech hook vol close","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"22212","name":"Incis 1 vertebral seg thorac","description":"Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; thoracic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["QB","RR","QF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77778","name":"Apply interstit radiat compl","description":"Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"44901","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"33130","name":"Rescj external cardiac tumor","description":"Resection of external cardiac tumor","date_of_service":"2026-05-10","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":"95934","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31591","name":"Laryngoplasty medialization","description":"Laryngoplasty, medialization, unilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64624","name":"Dstrj nulyt agt gnclr nrv","description":"Destruction by neurolytic agent, genicular nerve branches including imaging guidance, when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.16,"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":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2757.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-10","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":"01829","name":"Anes dx arthroscopic px wrst","description":"Anesthesia for diagnostic arthroscopic procedures on the wrist","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70220","name":"X-ray exam of sinuses","description":"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19182","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":608.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0174","name":"Cerv sr 2pc thor ext pre ots","description":"Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"62192","name":"Establish brain cavity shunt","description":"Creation of shunt; subarachnoid/subdural-peritoneal, -pleural, other terminus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0490","name":"Tlso rigid plastic pre one","description":"Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, res","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32609","name":"Thoracoscopy w/bx pleura","description":"Thoracoscopy; with biopsy(ies) of pleura","date_of_service":"2026-05-10","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":"73080","name":"X-ray exam of elbow","description":"Radiologic examination, elbow; complete, minimum of 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","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":"L5671","name":"Bk/ak locking mechanism","description":"Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0330T","name":"Tear film img uni/bi w/i&r","description":"Tear film imaging, unilateral or bilateral, with interpretation and report","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78700","name":"Kidney imaging morphol","description":"Kidney imaging morphology;","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6209","name":"Foam drsg <=16 sq in w/o bdr","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"78012","name":"Thyroid uptake measurement","description":"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56810","name":"Perineoplasty rpr per nonob","description":"Perineoplasty, repair of perineum, nonobstetrical (separate procedure)","date_of_service":"2026-05-10","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":"83698","name":"Assay lipoprotein pla2","description":"Lipoprotein-associated phospholipase a2 (lp-pla2)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"93505","name":"Endomyocardial biopsy","description":"Endomyocardial biopsy","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A5102","name":"Bedside drain btl w/wo tube","description":"Bedside drainage bottle with or without tubing, rigid or expandable, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"93613","name":"Intracardiac ephys 3d mapg","description":"Intracardiac electrophysiologic 3-dimensional mapping (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":512.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0158","name":"Walker leg extenders set of4","description":"Leg extensions for walker, per set of four (4)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"00902","name":"Anes anorectal px","description":"Anesthesia for; anorectal procedure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"20665","name":"Rmvl tongs/halo anthr indiv","description":"Removal of tongs or halo applied by another individual","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0968","name":"Wheelchair commode seat","description":"Commode seat, wheelchair","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57426","name":"Revise prosth vag graft lap","description":"Revision (including removal) of prosthetic vaginal graft, laparoscopic approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"H0005","name":"Alcohol and/or drug services","description":"Alcohol and/or drug services; group counseling by a clinician","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","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":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21407","name":"Opn tx orbit fx w/implant","description":"Open treatment of fracture of orbit, except blowout; with implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8509","name":"Trach-esoph voice pros md in","description":"Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.94,"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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74400","name":"Urography iv +-kub tomog","description":"Urography (pyelography), intravenous, with or without kub, with or without tomography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88188","name":"Flowcytometry/read 9-15","description":"Flow cytometry, interpretation; 9 to 15 markers","date_of_service":"2026-05-10","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":"28264","name":"Release of midfoot joint","description":"Capsulotomy, midtarsal (eg, heyman type procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"L0636","name":"Lso sagittal rigid panel cus","description":"Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressu","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28118","name":"Removal of heel bone","description":"Ostectomy, calcaneus;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95827","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"43651","name":"Laparoscopy vagus nerve","description":"Laparoscopy, surgical; transection of vagus nerves, truncal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29044","name":"Appl bdy cst sho to hip 1thi","description":"Application of body cast, shoulder to hips; including 1 thigh","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83030","name":"Hemoglobin f fetal chemical","description":"Hemoglobin; f (fetal), chemical","date_of_service":"2026-05-10","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":"83914","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"00912","name":"Anes trurl px rescj bldr tum","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of bladder tumor(s)","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-10","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":"78725","name":"Kidney function study","description":"Kidney function study, non-imaging radioisotopic study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1817","name":"Insulin for insulin pump use","description":"Insulin for administration through dme (i.e., insulin pump) per 50 units","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"25685","name":"Optx trns-scphprlnr fx dislc","description":"Open treatment of trans-scaphoperilunar type of fracture dislocation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":620.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1717","name":"Brachytx, non-str,hdr ir-192","description":"Brachytherapy source, non-stranded, high dose rate iridium-192, per source","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"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":"2026-05-10","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":"19366","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93278","name":"Ecg/signal-averaged","description":"Signal-averaged electrocardiography (saecg), with or without ecg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23455","name":"Repair shoulder capsule","description":"Capsulorrhaphy, anterior; with labral repair (eg, bankart procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1243.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5200","name":"Percutaneous catheter anchor","description":"Percutaneous catheter/tube anchoring device, adhesive skin attachment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1157.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2246.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"78605","name":"Brain image 4+ views","description":"Brain imaging, minimum 4 static views;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1468.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"33824","name":"Repair pda div 18 yrs&older","description":"Repair of patent ductus arteriosus; by division, 18 years and older","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1686","name":"Ho post-op hip abduction","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","date_of_service":"2026-05-10","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":"26580","name":"Repair cleft hand","description":"Repair cleft hand","date_of_service":"2026-05-10","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":"56405","name":"I&d vulva/perineal abscess","description":"Incision and drainage of vulva or perineal abscess","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92521","name":"Evaluation of speech fluency","description":"Evaluation of speech fluency (eg, stuttering, cluttering)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1821","name":"Replacement interface spsd","description":"Replacement soft interface material/cuffs for bi-directional static progressive stretch device","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93735","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"90847","name":"Family psytx w/pt 50 min","description":"Family psychotherapy (conjoint psychotherapy) (with patient present), 50 minutes","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":766.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01212","name":"Anes open px hip jt disrtcj","description":"Anesthesia for open procedures involving hip joint; hip disarticulation","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1115.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"E1180","name":"Wheelchair amputee w/ foot r","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable footrests","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00452","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"V2104","name":"Spherocylindr 4.00d/2.12-4d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"78605","name":"Brain image 4+ views","description":"Brain imaging, minimum 4 static views;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":651.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"B9004","name":"Parenteral infus pump portab","description":"Parenteral nutrition infusion pump, portable","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1513.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2313","name":"Lens sphc trifo 7.25-12/4.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"82106","name":"Alpha-fetoprotein amniotic","description":"Alpha-fetoprotein (afp); amniotic fluid","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"24360","name":"Reconstruct elbow joint","description":"Arthroplasty, elbow; with membrane (eg, fascial)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"93880","name":"Extracranial bilat study","description":"Duplex scan of extracranial arteries; complete bilateral study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1614.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1298","name":"Wheelchair spec seat depth/w","description":"Special wheelchair seat depth and/or width, by construction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93530","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35512","name":"Art byp grft subclav-brchial","description":"Bypass graft, with vein; subclavian-brachial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0602","name":"Repl batt silver oxide 3 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 3 volt, each","date_of_service":"2026-05-10","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":"43425","name":"Repair esophagus opening","description":"Closure of esophagostomy or fistula; transthoracic or transabdominal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1519.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":817.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J1510","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6955","name":"Above elbow myoelectronic ct","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"45136","name":"Excise ileoanal reservior","description":"Excision of ileoanal reservoir with ileostomy","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"83900","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82742","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85305","name":"Clot inhibit prot s total","description":"Clotting inhibitors or anticoagulants; protein s, total","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"21139","name":"Rdctj forehead cntrg&setback","description":"Reduction forehead; contouring and setback of anterior frontal sinus wall","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1196.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-10","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":"63252","name":"Revise spine cord vsl thrlmb","description":"Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracolumbar","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"27607","name":"Treat lower leg bone lesion","description":"Incision (eg, osteomyelitis or bone abscess), leg or ankle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"V2100","name":"Lens spher single plano 4.00","description":"Sphere, single vision, plano to plus or minus 4.00, per lens","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"77295","name":"3-d radiotherapy plan","description":"3-dimensional radiotherapy plan, including dose-volume histograms","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78469","name":"Heart infarct image (3d)","description":"Myocardial imaging, infarct avid, planar; tomographic spect with or without quantification","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"82104","name":"Alpha-1-antitrypsin pheno","description":"Alpha-1-antitrypsin; phenotype","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1552.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0291","name":"Hosp bed fx ht w/o rail w/o","description":"Hospital bed, fixed height, without side rails, without mattress","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":480.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29355","name":"Appl long leg cast walker","description":"Application of long leg cast (thigh to toes); walker or ambulatory type","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"94240","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":857.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"27443","name":"Revision of knee joint","description":"Arthroplasty, femoral condyles or tibial plateau(s), knee; with debridement and partial synovectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","date_of_service":"2026-05-10","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":"35536","name":"Art byp grft splenorenal","description":"Bypass graft, with vein; splenorenal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2193.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92065","name":"Orthop traing pfrmd phys/qhp","description":"Orthoptic training; performed by a physician or other qualified health care professional","date_of_service":"2026-05-10","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":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84087","name":"Assay phosphohexose enzymes","description":"Phosphohexose isomerase","date_of_service":"2026-05-10","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":"87277","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"38570","name":"Laparoscopy lymph node biop","description":"Laparoscopy, surgical; with retroperitoneal lymph node sampling (biopsy), single or multiple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1567","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1044.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"55250","name":"Removal of sperm duct(s)","description":"Vasectomy, unilateral or bilateral (separate procedure), including postoperative semen examination(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"76705","name":"Echo exam of abdomen","description":"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"35450","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1050","name":"Whelchr fxd full length arms","description":"Fully-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q9945","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"70140","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; less than 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","date_of_service":"2026-05-10","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":"88349","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7320","name":"Genvisc 850, inj, 1mg","description":"Hyaluronan or derivitive, genvisc 850, for intra-articular injection, 1 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"59072","name":"Umbilical cord occlud w/us","description":"Fetal umbilical cord occlusion, including ultrasound guidance","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-05-10","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":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1207.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-10","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":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90586","name":"Bcg vaccine intravesical","description":"Bacillus calmette-guerin vaccine (bcg) for bladder cancer, live, for intravesical use","date_of_service":"2026-05-10","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":118.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51050","name":"Removal of bladder stone","description":"Cystolithotomy, cystotomy with removal of calculus, without vesical neck resection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":485.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1457.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49041","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1355.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21454","name":"Optx mndblr fx xtrnl fixj","description":"Open treatment of mandibular fracture with external fixation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1631","name":"Haloperidol decanoate inj","description":"Injection, haloperidol decanoate, per 50 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5505","name":"Init ak ischal plstr direct","description":"Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","date_of_service":"2026-05-10","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":"77333","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; intermediate (multiple blocks, stents, bite blocks, special bolus)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77295","name":"3-d radiotherapy plan","description":"3-dimensional radiotherapy plan, including dose-volume histograms","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00522","name":"Anes clsd ch px ndl bx pleur","description":"Anesthesia for closed chest procedures; needle biopsy of pleura","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"E1221","name":"Wheelchair spec size w foot","description":"Wheelchair with fixed arm, footrests","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1512.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69820","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":627.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28116","name":"Revision of foot","description":"Ostectomy, excision of tarsal coalition","date_of_service":"2026-05-10","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":"63277","name":"Bx/exc xdrl spine lesn lmbr","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, lumbar","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1764.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"21032","name":"Remove exostosis maxilla","description":"Excision of maxillary torus palatinus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"84525","name":"Urea nitrogen semi-quant","description":"Urea nitrogen; semiquantitative (eg, reagent strip test)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2045.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4565","name":"Slings","description":"Slings","date_of_service":"2026-05-10","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":"58322","name":"Artificial insemination","description":"Artificial insemination; intra-uterine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92354","name":"Fitg spect low vis 1system","description":"Fitting of spectacle mounted low vision aid; single element system","date_of_service":"2026-05-10","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":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1042.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95822","name":"Eeg coma or sleep only","description":"Electroencephalogram (eeg); recording in coma or sleep only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-10","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":"51590","name":"Remove bladder/revise tract","description":"Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including intestine anastomosis;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1569.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"35761","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0745","name":"Neuromuscular stim for shock","description":"Neuromuscular stimulator, electronic shock unit","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0390","name":"Chloroquine injection","description":"Injection, chloroquine hydrochloride, up to 250 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27698","name":"Repair of ankle ligament","description":"Repair, secondary, disrupted ligament, ankle, collateral (eg, watson-jones procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00532","name":"Anes access ctr venous crcj","description":"Anesthesia for access to central venous circulation","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"C9113","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":917.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8621","name":"Repl zinc air battery","description":"Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1371.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":561.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0606","name":"Drainage board postural","description":"Postural drainage board","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52620","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1447.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6441","name":"Pad band w>=3in <5in/yd","description":"Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88140","name":"Sex chromatin identification","description":"Sex chromatin identification; peripheral blood smear, polymorphonuclear drumsticks","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"86706","name":"Hep b surface antibody","description":"Hepatitis b surface antibody (hbsab)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4311","name":"Catheter w/o bag 2-way latex","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"61546","name":"Removal of pituitary gland","description":"Craniotomy for hypophysectomy or excision of pituitary tumor, intracranial approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2599.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","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":"89190","name":"Nasal smear for eosinophils","description":"Nasal smear for eosinophils","date_of_service":"2026-05-10","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":"71010","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"A4390","name":"Drainable pch ex wear convex","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"J9110","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"49427","name":"Injection abdominal shunt","description":"Injection procedure (eg, contrast media) for evaluation of previously placed peritoneal-venous shunt","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70210","name":"X-ray exam of sinuses","description":"Radiologic examination, sinuses, paranasal, less than 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2600","name":"Hip clevis/thrust bearing fr","description":"Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75685","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2102","name":"Singl visn sphere 7.12-20.00","description":"Sphere, single vision, plus or minus 7.12 to plus or minus 20.00d, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"59000","name":"Amniocentesis diagnostic","description":"Amniocentesis; diagnostic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6692","name":"Silicon gel insert w/wo lock","description":"Upper extremity addition, silicone gel insert or equal, with or without locking mechanism, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86710","name":"Influenza virus antibody","description":"Antibody; influenza virus","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"69905","name":"Remove inner ear","description":"Labyrinthectomy; transcanal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93561","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43252","name":"Egd optical endomicroscopy","description":"Esophagogastroduodenoscopy, flexible, transoral; with optical endomicroscopy","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"48001","name":"Placement of drain pancreas","description":"Placement of drains, peripancreatic, for acute pancreatitis; with cholecystostomy, gastrostomy, and jejunostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1941.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64788","name":"Remove skin nerve lesion","description":"Excision of neurofibroma or neurolemmoma; cutaneous nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36005","name":"Injection ext venography","description":"Injection procedure for extremity venography (including introduction of needle or intracatheter)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84478","name":"Assay of triglycerides","description":"Triglycerides","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":620.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"65820","name":"Goniotomy","description":"Goniotomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2820.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"64560","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78598","name":"Lung perf&ventilat diferentl","description":"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83055","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"L8605","name":"Inj bulking agent anal canal","description":"Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8603","name":"Collagen imp urinary 2.5 ml","description":"Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76075","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24577","name":"Cltx humrl cndylr fx w/mnpj","description":"Closed treatment of humeral condylar fracture, medial or lateral; with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":462.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"84430","name":"Assay of thiocyanate","description":"Thiocyanate","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"28225","name":"Release of foot tendon","description":"Tenolysis, extensor, foot; single tendon","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6451","name":"Mod compres band w>=3in<5in/yd","description":"Moderate compression bandage, elastic, knitted/woven, load resistance of 1.25 to 1.34 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"56810","name":"Perineoplasty rpr per nonob","description":"Perineoplasty, repair of perineum, nonobstetrical (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84305","name":"Assay of somatomedin","description":"Somatomedin","date_of_service":"2026-05-10","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":"23455","name":"Repair shoulder capsule","description":"Capsulorrhaphy, anterior; with labral repair (eg, bankart procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":838.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":"90683","name":"Rsv vacc mrna lipid nano im","description":"Respiratory syncytial virus vaccine, mrna lipid nanoparticles, for intramuscular use","date_of_service":"2026-05-10","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":363.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"78001","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"J1110","name":"Inj dihydroergotamine mesylt","description":"Injection, dihydroergotamine mesylate, per 1 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1228.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3808","name":"Whfo, rigid w/o joints","description":"Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0520","name":"Bethanechol chloride inject","description":"Injection, bethanechol chloride, myotonachol or urecholine, up to 5 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20920","name":"Removal of fascia for graft","description":"Fascia lata graft; by stripper","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47511","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"77031","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86901","name":"Blood typing serologic rh(d)","description":"Blood typing, serologic; rh (d)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","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":"64784","name":"Remove nerve lesion","description":"Excision of neuroma; major peripheral nerve, except sciatic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":806.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53515","name":"Repair of urethra injury","description":"Urethrorrhaphy, suture of urethral wound or injury; prostatomembranous","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88173","name":"Cytopath eval fna report","description":"Cytopathology, evaluation of fine needle aspirate; interpretation and report","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29358","name":"Appl long leg cast brace","description":"Application of long leg cast brace","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74327","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"27435","name":"Incision of knee joint","description":"Capsulotomy, posterior capsular release, knee","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86490","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77615","name":"Hyperthermia ntrstl prb>5","description":"Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators","date_of_service":"2026-05-10","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":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29844","name":"Wrist arthroscopy/surgery","description":"Arthroscopy, wrist, surgical; synovectomy, partial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"82003","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2237.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22222","name":"Osteot dsc ant 1vrt sgm thrc","description":"Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; thoracic","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"82627","name":"Dehydroepiandrosterone","description":"Dehydroepiandrosterone-sulfate (dhea-s)","date_of_service":"2026-05-10","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":"L5500","name":"Init bk ptb plaster direct","description":"Initial, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69650","name":"Stapes mobilization","description":"Stapes mobilization","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":915.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19180","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1473.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G2062","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"23071","name":"Exc shoulder les sc 3 cm/>","description":"Excision, tumor, soft tissue of shoulder area, subcutaneous; 3 cm or greater","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75840","name":"Vein x-ray adrenal gland","description":"Venography, adrenal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44340","name":"Revision of colostomy","description":"Revision of colostomy; simple (release of superficial scar) (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":508.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1524.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"47612","name":"Removal of gallbladder","description":"Cholecystectomy with exploration of common duct; with choledochoenterostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35875","name":"Removal of clot in graft","description":"Thrombectomy of arterial or venous graft (other than hemodialysis graft or fistula);","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"74475","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"62100","name":"Repair brain fluid leakage","description":"Craniotomy for repair of dural/cerebrospinal fluid leak, including surgery for rhinorrhea/otorrhea","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1815.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"C9224","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1812.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35331","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; abdominal aorta","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1841.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"90814","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":972.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43193","name":"Esophagoscp rig trnso biopsy","description":"Esophagoscopy, rigid, transoral; with biopsy, single or multiple","date_of_service":"2026-05-10","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":"85705","name":"Thromboplastin inhibition","description":"Thromboplastin inhibition, tissue","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","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":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1334.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"G0364","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7010","name":"Disposable corrugated tubing","description":"Corrugated tubing, disposable, used with large volume nebulizer, 100 feet","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","date_of_service":"2026-05-10","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":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"63710","name":"Graft repair of spine defect","description":"Dural graft, spinal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1223.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J2310","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"74455","name":"X-ray urethra/bladder","description":"Urethrocystography, voiding, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"82120","name":"Amines vaginal fluid qual","description":"Amines, vaginal fluid, qualitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"49905","name":"Omental flap intra-abdom","description":"Omental flap, intra-abdominal (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"J2270","name":"Morphine sulfate injection","description":"Injection, morphine sulfate, up to 10 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76965","name":"Echo guidance radiotherapy","description":"Ultrasonic guidance for interstitial radioelement application","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5971","name":"Sach foot, replacement","description":"All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":"95904","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4393","name":"Urine pch w ex wear bar conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"66711","name":"Ecp ciliary body destruction","description":"Ciliary body destruction; cyclophotocoagulation, endoscopic, without concomitant removal of crystalline lens","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1276.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"52282","name":"Cystoscopy implant stent","description":"Cystourethroscopy, with insertion of permanent urethral stent","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-10","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":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"37222","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1405","name":"O2/water vapor enrich w/heat","description":"Oxygen and water vapor enriching system with heated delivery","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"J2515","name":"Pentobarbital sodium inj","description":"Injection, pentobarbital sodium, per 50 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20665","name":"Rmvl tongs/halo anthr indiv","description":"Removal of tongs or halo applied by another individual","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58925","name":"Removal of ovarian cyst(s)","description":"Ovarian cystectomy, unilateral or bilateral","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2436.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2300","name":"Inj nalbuphine hydrochloride","description":"Injection, nalbuphine hydrochloride, per 10 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3764","name":"Ewho w/joint(s) cf","description":"Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21627","name":"Sternal debridement","description":"Sternal debridement","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"33617","name":"Repair single ventricle","description":"Repair of complex cardiac anomalies (eg, single ventricle) by modified fontan procedure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1881.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90875","name":"Psychophysiological therapy","description":"Individual psychophysiological therapy incorporating biofeedback training by any modality (face-to-face with the patient), with psychotherapy (eg, insight oriented, behavior modifying or supportive psychotherapy); 30 minutes","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"93610","name":"Intra-atrial pacing","description":"Intra-atrial pacing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1435","name":"Injection estrone per 1 mg","description":"Injection, estrone, per 1 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1183.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30430","name":"Revision of nose","description":"Rhinoplasty, secondary; minor revision (small amount of nasal tip work)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29025","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"21188","name":"Reconstruction of midface","description":"Reconstruction midface, osteotomies (other than lefort type) and bone grafts (includes obtaining autografts)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70110","name":"X-ray exam of jaw 4/> views","description":"Radiologic examination, mandible; complete, minimum of 4 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"29848","name":"Wrist endoscopy/surgery","description":"Endoscopy, wrist, surgical, with release of transverse carpal ligament","date_of_service":"2026-05-10","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":"82642","name":"Dihydrotestosterone","description":"Dihydrotestosterone (dht)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2134","name":"Kafo fem fx cast semi-rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35211","name":"Rpr blvsl dir ntrathrc w/byp","description":"Repair blood vessel, direct; intrathoracic, with bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J1250","name":"Inj dobutamine hcl/250 mg","description":"Injection, dobutamine hydrochloride, per 250 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01650","name":"Anes art sho&ax nos","description":"Anesthesia for procedures on arteries of shoulder and axilla; not otherwise specified","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36262","name":"Removal of infusion pump","description":"Removal of implanted intra-arterial infusion pump","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"78806","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-10","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":"59412","name":"Antepartum manipulation","description":"External cephalic version, with or without tocolysis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29807","name":"Sho arthrs srg rpr slap les","description":"Arthroscopy, shoulder, surgical; repair of slap lesion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":"31805","name":"Repair of windpipe injury","description":"Suture of tracheal wound or injury; intrathoracic","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","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":"26600","name":"Treat metacarpal fracture","description":"Closed treatment of metacarpal fracture, single; without manipulation, each bone","date_of_service":"2026-05-10","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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","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":"2026-05-10","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":"75665","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"82544","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":"27248","name":"Treat thigh fracture","description":"Open treatment of greater trochanteric fracture, includes internal fixation, when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"64726","name":"Dcmprn plantar digital nerve","description":"Decompression; plantar digital nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"33875","name":"Thoracic aortic graft","description":"Descending thoracic aorta graft, with or without bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2322.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J9375","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E1820","name":"Soft interface material","description":"Replacement soft interface material, dynamic adjustable extension/flexion device","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":523.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"33737","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1614.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70134","name":"X-ray exam of middle ear","description":"Radiologic examination, internal auditory meati, complete","date_of_service":"2026-05-10","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":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"00908","name":"Anes perineal prostatectomy","description":"Anesthesia for; perineal prostatectomy","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95928","name":"C motor evoked uppr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); upper limbs","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6242","name":"Hydrogel drg <=16 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6709","name":"Term dev mech hand vol close","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":610.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":620.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"84307","name":"Assay of somatostatin","description":"Somatostatin","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"30320","name":"Remove nasal foreign body","description":"Removal foreign body, intranasal; by lateral rhinotomy","date_of_service":"2026-05-10","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":"78291","name":"Pertl-ven shunt patency test","description":"Peritoneal-venous shunt patency test (eg, for leveen, denver shunt)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70310","name":"X-ray exam of teeth","description":"Radiologic examination, teeth; partial examination, less than full mouth","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2607.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85048","name":"Automated leukocyte count","description":"Blood count; leukocyte (wbc), automated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55540","name":"Revise hernia & sperm veins","description":"Excision of varicocele or ligation of spermatic veins for varicocele; with hernia repair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":553.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":544.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73700","name":"Ct lower extremity w/o dye","description":"Computed tomography, lower extremity; without contrast material","date_of_service":"2026-05-10","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":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86156","name":"Cold agglutinin screen","description":"Cold agglutinin; screen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1072.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-10","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":"26262","name":"Resect distal finger tumor","description":"Radical resection of tumor, distal phalanx of finger","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":542.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"38220","name":"Dx bone marrow aspirations","description":"Diagnostic bone marrow; aspiration(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43227","name":"Esophagoscopy control bleed","description":"Esophagoscopy, flexible, transoral; with control of bleeding, any method","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"46040","name":"I&d ischiorct&/perirct absc","description":"Incision and drainage of ischiorectal and/or perirectal abscess (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L1500","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93616","name":"Esophageal recording w/pacg","description":"Esophageal recording of atrial electrogram with or without ventricular electrogram(s); with pacing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1230","name":"Power operated vehicle","description":"Power operated vehicle (three or four wheel nonhighway) specify brand name and model number","date_of_service":"2026-05-10","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":"89160","name":"Exam feces for meat fibers","description":"Meat fibers, feces","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"77333","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; intermediate (multiple blocks, stents, bite blocks, special bolus)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25606","name":"Perq skel fixj dstl rdl fx","description":"Percutaneous skeletal fixation of distal radial fracture or epiphyseal separation","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","date_of_service":"2026-05-10","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":"36002","name":"Pseudoaneurysm injection trt","description":"Injection procedures (eg, thrombin) for percutaneous treatment of extremity pseudoaneurysm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95936","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"76872","name":"Us transrectal","description":"Ultrasound, transrectal;","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"78003","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0145","name":"Scr c/v cyto,thinlayer,rescr","description":"Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-10","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":"78264","name":"Gastric emptying img study","description":"Gastric emptying imaging study (eg, solid, liquid, or both);","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5331","name":"Hip disart canadian sach ft","description":"Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"76818","name":"Fetal biophys profile w/nst","description":"Fetal biophysical profile; with non-stress testing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":917.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70545","name":"Mr angiography head w/dye","description":"Magnetic resonance angiography, head; with contrast material(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":647.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","date_of_service":"2026-05-10","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":"00103","name":"Anes rcnstv px eyelid","description":"Anesthesia for reconstructive procedures of eyelid (eg, blepharoplasty, ptosis surgery)","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2430.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"37205","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88355","name":"M/phmtrc alys skeletal musc","description":"Morphometric analysis; skeletal muscle","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63700","name":"Repair of spinal herniation","description":"Repair of meningocele; less than 5 cm diameter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":758.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"82436","name":"Assay of urine chloride","description":"Chloride; urine","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2102.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"24920","name":"Amputation of upper arm","description":"Amputation, arm through humerus; open, circular (guillotine)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":822.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"2026-05-10","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":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","date_of_service":"2026-05-10","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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-10","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":"61795","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65286","name":"Repair of eye wound","description":"Repair of laceration; application of tissue glue, wounds of cornea and/or sclera","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84702","name":"Chorionic gonadotropin test","description":"Gonadotropin, chorionic (hcg); quantitative","date_of_service":"2026-05-10","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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"24365","name":"Reconstruct head of radius","description":"Arthroplasty, radial head;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42900","name":"Repair throat wound","description":"Suture pharynx for wound or injury","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93931","name":"Upper extremity study","description":"Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or limited study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83858","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-10","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":"94729","name":"Diffusing capacity","description":"Diffusing capacity (eg, carbon monoxide, membrane) (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36260","name":"Insertion of infusion pump","description":"Insertion of implantable intra-arterial infusion pump (eg, for chemotherapy of liver)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":567.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6884","name":"Replc sockt above elbow disa","description":"Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"62140","name":"Crnop skull defect<5 cm diam","description":"Cranioplasty for skull defect; up to 5 cm diameter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1158.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00870","name":"Anes xtrprtl cystolithotomy","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; cystolithotomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93532","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2343","name":"W/c dpth 22-25 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"32852","name":"Lung transplant with bypass","description":"Lung transplant, single; with cardiopulmonary bypass","date_of_service":"2026-05-10","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":"28360","name":"Reconstruct cleft foot","description":"Reconstruction, cleft foot","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"K0737","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"27768","name":"Cltx post ankle fx w/mnpj","description":"Closed treatment of posterior malleolus fracture; with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77470","name":"Special radiation treatment","description":"Special treatment procedure (eg, total body irradiation, hemibody radiation, per oral or endocavitary irradiation)","date_of_service":"2026-05-10","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":"76970","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"J1162","name":"Digoxin immune fab (ovine)","description":"Injection, digoxin immune fab (ovine), per vial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":540.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":579.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":481.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"35585","name":"Vein byp fem-tibial peroneal","description":"In-situ vein bypass; femoral-anterior tibial, posterior tibial, or peroneal artery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"85547","name":"Rbc mechanical fragility","description":"Mechanical fragility, rbc","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"72198","name":"Mr angio pelvis w/o & w/dye","description":"Magnetic resonance angiography, pelvis, with or without contrast material(s)","date_of_service":"2026-05-10","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":"92551","name":"Pure tone hearing test air","description":"Screening test, pure tone, air only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":692.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0749","name":"Elec osteogen stim implanted","description":"Osteogenesis stimulator, electrical, surgically implanted","date_of_service":"2026-05-10","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":"27147","name":"Revision of hip bone","description":"Osteotomy, iliac, acetabular or innominate bone; with open reduction of hip","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64865","name":"Repair of facial nerve","description":"Suture of facial nerve; infratemporal, with or without grafting","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"33422","name":"Revision of mitral valve","description":"Valvotomy, mitral valve; open heart, with cardiopulmonary bypass","date_of_service":"2026-05-10","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":"27516","name":"Treat thigh fx growth plate","description":"Closed treatment of distal femoral epiphyseal separation; without manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":532.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1527.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"45000","name":"Drainage of pelvic abscess","description":"Transrectal drainage of pelvic abscess","date_of_service":"2026-05-10","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":"V2782","name":"Lens, 1.54-1.65 p/1.60-1.79g","description":"Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"90849","name":"Multiple family group psytx","description":"Multiple-family group psychotherapy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"76998","name":"Us guide intraop","description":"Ultrasonic guidance, intraoperative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15736","name":"Muscle-skin graft arm","description":"Muscle, myocutaneous, or fasciocutaneous flap; upper extremity","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q4080","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19371","name":"Peri-implt capslc brst compl","description":"Peri-implant capsulectomy, breast, complete, including removal of all intracapsular contents","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"92541","name":"Spontaneous nystagmus test","description":"Spontaneous nystagmus test, including gaze and fixation nystagmus, with recording","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"30130","name":"Excise inferior turbinate","description":"Excision inferior turbinate, partial or complete, any method","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2280","name":"Molded inner boot","description":"Addition to lower extremity, molded inner boot","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"43350","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8621","name":"Repl zinc air battery","description":"Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97139","name":"Unlisted therapeutic px","description":"Unlisted therapeutic procedure (specify)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0455","name":"Tlso flex trnk sj-t9 pre ots","description":"Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, pref","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68720","name":"Create tear sac drain","description":"Dacryocystorhinostomy (fistulization of lacrimal sac to nasal cavity)","date_of_service":"2026-05-10","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":"19328","name":"Rmvl intact breast implant","description":"Removal of intact breast implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":529.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27871","name":"Fusion of tibiofibular joint","description":"Arthrodesis, tibiofibular joint, proximal or distal","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":671.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5682","name":"Bk thigh lacer glut/ischia m","description":"Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-10","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":"86653","name":"Encephaltis st louis antbody","description":"Antibody; encephalitis, st. louis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"93603","name":"Right ventricular recording","description":"Right ventricular recording","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33332","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95911","name":"Nrv cndj test 9-10 studies","description":"Nerve conduction studies; 9-10 studies","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88741","name":"Transcutaneous methb","description":"Hemoglobin, quantitative, transcutaneous, per day; methemoglobin","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L2387","name":"Add le poly knee custom kafo","description":"Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-10","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":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"93041","name":"Rhythm ecg tracing","description":"Rhythm ecg, 1-3 leads; tracing only without interpretation and report","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32540","name":"Removal of lung lesion","description":"Extrapleural enucleation of empyema (empyemectomy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1385.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64907","name":"Nerve pedicle transfer","description":"Nerve pedicle transfer; second stage","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","date_of_service":"2026-05-10","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":"86701","name":"Hiv-1antibody","description":"Antibody; hiv-1","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43351","name":"Surgical opening esophagus","description":"Esophagostomy, fistulization of esophagus, external; thoracic approach","date_of_service":"2026-05-10","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":"90816","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2745","name":"Tint, any color/solid/grad","description":"Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"44130","name":"Bowel to bowel fusion","description":"Enteroenterostomy, anastomosis of intestine, with or without cutaneous enterostomy (separate procedure)","date_of_service":"2026-05-10","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":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"83527","name":"Assay of insulin","description":"Insulin; free","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26516","name":"Fusion of knuckle joint","description":"Capsulodesis, metacarpophalangeal joint; single digit","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-10","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":"26236","name":"Partial removal finger bone","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis); distal phalanx of finger","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1728.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86332","name":"Immune complex assay","description":"Immune complex assay","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1490.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0603","name":"Electric breast pump","description":"Breast pump, electric (ac and/or dc), any type","date_of_service":"2026-05-10","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":"77332","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; simple (simple block, simple bolus)","date_of_service":"2026-05-10","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":"L0972","name":"Lso corset front","description":"Lso, corset front","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"47561","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45335","name":"Sigmoidoscopy w/submuc inj","description":"Sigmoidoscopy, flexible; with directed submucosal injection(s), any substance","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2107","name":"Spherocylinder 4.25d/12-2d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"37234","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70220","name":"X-ray exam of sinuses","description":"Radiologic examination, sinuses, paranasal, complete, minimum of 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75820","name":"Vein x-ray arm/leg","description":"Venography, extremity, unilateral, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"19366","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61450","name":"Crnec stpl sctj cmprn/dcmprn","description":"Craniectomy, subtemporal, for section, compression, or decompression of sensory root of gasserian ganglion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"48000","name":"Drainage of abdomen","description":"Placement of drains, peripancreatic, for acute pancreatitis;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5972","name":"Flexible keel foot","description":"All lower extremity prostheses, foot, flexible keel","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0450","name":"Tlso flex trunk/thor pre ots","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78635","name":"Csf ventriculography","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography","date_of_service":"2026-05-10","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":"77427","name":"Radiation tx management x5","description":"Radiation treatment management, 5 treatments","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"71101","name":"X-ray exam unilat ribs/chest","description":"Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views","date_of_service":"2026-05-10","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":"93024","name":"Ergonovine provocation test","description":"Ergonovine provocation test","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20660","name":"Apply rem fixation device","description":"Application of cranial tongs, caliper, or stereotactic frame, including removal (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"69505","name":"Remove mastoid structures","description":"Mastoidectomy; modified radical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86160","name":"Complement antigen","description":"Complement; antigen, each component","date_of_service":"2026-05-10","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":"61514","name":"Crnec treph exc brn abs sttl","description":"Craniectomy, trephination, bone flap craniotomy; for excision of brain abscess, supratentorial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2128.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"44201","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":701.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","date_of_service":"2026-05-10","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":"43653","name":"Laparoscopy gastrostomy","description":"Laparoscopy, surgical; gastrostomy, without construction of gastric tube (eg, stamm procedure) (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1759.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27075","name":"Resect hip tumor","description":"Radical resection of tumor; wing of ilium, 1 pubic or ischial ramus or symphysis pubis","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"G6015","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2509.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6712","name":"Ped term dev, hook, vol clos","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":881.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5673","name":"Socket insert w lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":776.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"A4459","name":"Transanal irrigation, any","description":"Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72129","name":"Ct chest spine w/dye","description":"Computed tomography, thoracic spine; with contrast material","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2085.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4997.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51520","name":"Removal of bladder lesion","description":"Cystotomy; for simple excision of vesical neck (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"27345","name":"Removal of knee cyst","description":"Excision of synovial cyst of popliteal space (eg, bakers cyst)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"47381","name":"Open ablate liver tumor cryo","description":"Ablation, open, of 1 or more liver tumor(s); cryosurgical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93527","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","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":"2026-05-10","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":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"33496","name":"Repair prosth valve clot","description":"Repair of non-structural prosthetic valve dysfunction with cardiopulmonary bypass (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1975.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"54640","name":"Orchiopexy ingun/scrot appr","description":"Orchiopexy, inguinal or scrotal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93600","name":"Bundle of his recording","description":"Bundle of his recording","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78231","name":"Salivary glnd img serial img","description":"Salivary gland imaging; with serial images","date_of_service":"2026-05-10","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":"A6448","name":"Lt compres band <3in/yd","description":"Light compression bandage, elastic, knitted/woven, width less than three inches, per yard","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"84210","name":"Assay of pyruvate","description":"Pyruvate","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64782","name":"Remove limb nerve lesion","description":"Excision of neuroma; hand or foot, except digital nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6545","name":"Grad com non-elastic bk surg","description":"Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["AW"]}],"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":"2026-05-10","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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92065","name":"Orthop traing pfrmd phys/qhp","description":"Orthoptic training; performed by a physician or other qualified health care professional","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00148","name":"Anes px eye ophthalmoscopy","description":"Anesthesia for procedures on eye; ophthalmoscopy","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"76001","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4433","name":"Urine ost pch bar w lock fln","description":"Ostomy pouch, urinary; for use on barrier with locking flange (2 piece), each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2540","name":"Penicillin g potassium inj","description":"Injection, penicillin g potassium, up to 600,000 units","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90660","name":"Laiv3 vaccine intranasal","description":"Influenza virus vaccine, trivalent, live (laiv3), for intranasal use","date_of_service":"2026-05-10","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":29.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29843","name":"Wrist arthroscopy/surgery","description":"Arthroscopy, wrist, surgical; for infection, lavage and drainage","date_of_service":"2026-05-10","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":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"92015","name":"Determine refractive state","description":"Determination of refractive state","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1158.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"82785","name":"Assay of ige","description":"Gammaglobulin (immunoglobulin); ige","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86710","name":"Influenza virus antibody","description":"Antibody; influenza virus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7400","name":"Add ue prost be/wd, ultlite","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"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":"74430","name":"Contrast x-ray bladder","description":"Cystography, minimum of 3 views, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"30430","name":"Revision of nose","description":"Rhinoplasty, secondary; minor revision (small amount of nasal tip work)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":788.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26590","name":"Repair finger deformity","description":"Repair macrodactylia, each digit","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1574.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28220","name":"Release of foot tendon","description":"Tenolysis, flexor, foot; single tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5962","name":"Below knee flex cover system","description":"Addition, endoskeletal system, below knee, flexible protective outer surface covering system","date_of_service":"2026-05-10","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":"42500","name":"Repair salivary duct","description":"Plastic repair of salivary duct, sialodochoplasty; primary or simple","date_of_service":"2026-05-10","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":"E1840","name":"Adj shoulder ext/flex device","description":"Dynamic adjustable shoulder flexion / abduction / rotation device, includes soft interface material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":786.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3900","name":"Hinge extension/flex wrist/f","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"20250","name":"Biopsy vrt bdy open thoracic","description":"Biopsy, vertebral body, open; thoracic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0740","name":"Non-implant pelv flr e-stim","description":"Non-implanted pelvic floor electrical stimulator, complete system","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":954.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78607","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":574.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["26"]}],"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":"2026-05-10","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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1991.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98929","name":"Osteopath manj 9-10 regions","description":"Osteopathic manipulative treatment (omt); 9-10 body regions involved","date_of_service":"2026-05-10","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":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"27275","name":"Manipulation of hip joint","description":"Manipulation, hip joint, requiring general anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96922","name":"Excimer lsr psriasis>500sqcm","description":"Excimer laser treatment for psoriasis; over 500 sq cm","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6244","name":"Hydrogel drg >48 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1002.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":519.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32151","name":"Remove lung foreign body","description":"Thoracotomy; with removal of intrapulmonary foreign body","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":992.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"54500","name":"Biopsy of testis","description":"Biopsy of testis, needle (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"83735","name":"Assay of magnesium","description":"Magnesium","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1867.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G2064","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33240","name":"Insrt pulse gen w/singl lead","description":"Insertion of implantable defibrillator pulse generator only; with existing single lead","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"50135","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":907.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5650","name":"Tot contact ak/knee disart s","description":"Additions to lower extremity, total contact, above knee or knee disarticulation socket","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":779.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3670.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"62180","name":"Establish brain cavity shunt","description":"Ventriculocisternostomy (torkildsen type operation)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1756.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"72200","name":"X-ray exam si joints","description":"Radiologic examination, sacroiliac joints; less than 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"82045","name":"Albumin ischemia modified","description":"Albumin; ischemia modified","date_of_service":"2026-05-10","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":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"67911","name":"Revise eyelid defect","description":"Correction of lid retraction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"77750","name":"Infuse radioactive materials","description":"Infusion or instillation of radioelement solution (includes 3-month follow-up care)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0373","name":"Nonpowered pressure mattress","description":"Nonpowered advanced pressure reducing mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48556","name":"Removal allograft pancreas","description":"Removal of transplanted pancreatic allograft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1152.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"87900","name":"Phenotype infect agent drug","description":"Infectious agent drug susceptibility phenotype prediction using regularly updated genotypic bioinformatics","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1468.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"55535","name":"Revise spermatic cord veins","description":"Excision of varicocele or ligation of spermatic veins for varicocele; abdominal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95015","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2205","name":"Lens sphcy bifocal 4.00d/4.2","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94642","name":"Aerosol inhalation treatment","description":"Aerosol inhalation of pentamidine for pneumocystis carinii pneumonia treatment or prophylaxis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85170","name":"Blood clot retraction","description":"Clot retraction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29049","name":"Appl cast figure-of-eight","description":"Application, cast; figure-of-eight","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72192","name":"Ct pelvis w/o dye","description":"Computed tomography, pelvis; without contrast material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2036","name":"Kafo plas doub free knee mol","description":"Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2618","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96921","name":"Excimer lsr psriasis 250-500","description":"Excimer laser treatment for psoriasis; 250 sq cm to 500 sq cm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50930","name":"Closure ureter/bowel fistula","description":"Closure of ureterovisceral fistula (including visceral repair)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99234","name":"Hosp ip/obs sm dt sf/low 45","description":"Hospital inpatient or observation care, for the evaluation and management of a patient including admission and discharge on the same date, which requires a medically appropriate history and/or examination and straightforward or low level of medical decision making. when using total time on the date ","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76870","name":"Us exam scrotum","description":"Ultrasound, scrotum and contents","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"91321","name":"Sarscov2 vac 25 mcg/.25ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, 25 mcg/0.25 ml dosage, for intramuscular use","date_of_service":"2026-05-10","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":128.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4428","name":"Urine ost pouch w faucet/tap","description":"Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"90677","name":"Pcv20 vaccine im","description":"Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use","date_of_service":"2026-05-10","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":341.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"27704","name":"Removal of ankle implant","description":"Removal of ankle implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":659.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"0212T","name":"Compre audiometry evaluation","description":"Comprehensive audiometry threshold evaluation and speech recognition (0209t, 0211t combined), automated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":"E1800","name":"Adjust elbow ext & flex dev","description":"Dynamic adjustable elbow extension and flexion device, includes soft interface material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0008","name":"Admin influenza virus vac","description":"Administration of influenza virus vaccine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"63746","name":"Removal of spinal shunt","description":"Removal of entire lumbosubarachnoid shunt system without replacement","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1224.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74475","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"33364","name":"Replace aortic valve open","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; open iliac artery approach","date_of_service":"2026-05-10","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":"78018","name":"Thyroid met imaging body","description":"Thyroid carcinoma metastases imaging; whole body","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"75978","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":809.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64864","name":"Repair of facial nerve","description":"Suture of facial nerve; extracranial","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43420","name":"Repair esophagus opening","description":"Closure of esophagostomy or fistula; cervical approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1028.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","date_of_service":"2026-05-10","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":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":771.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":825.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":503.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1777.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"23931","name":"I&d upr a/e bursa","description":"Incision and drainage, upper arm or elbow area; bursa","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83632","name":"Placental lactogen","description":"Lactogen, human placental (hpl) human chorionic somatomammotropin","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":893.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70490","name":"Ct soft tissue neck w/o dye","description":"Computed tomography, soft tissue neck; without contrast material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29445","name":"Appl rigid tot cntc leg cast","description":"Application of rigid total contact leg cast","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67318","name":"Revise eye muscle(s)","description":"Strabismus surgery, any procedure, superior oblique muscle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":675.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1529.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":476.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":683.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01340","name":"Anes clsd px lower 1/3 femur","description":"Anesthesia for all closed procedures on lower one-third of femur","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"49587","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KL"]}],"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":"2026-05-10","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":"26686","name":"Treat hand dislocation","description":"Open treatment of carpometacarpal dislocation, other than thumb; complex, multiple, or delayed reduction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":526.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90937","name":"Hemodialysis repeated eval","description":"Hemodialysis procedure requiring repeated evaluation(s) with or without substantial revision of dialysis prescription","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"21700","name":"Revision of neck muscle","description":"Division of scalenus anticus; without resection of cervical rib","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67121","name":"Remove eye implant material","description":"Removal of implanted material, posterior segment; intraocular","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":543.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"82232","name":"Assay of beta-2 protein","description":"Beta-2 microglobulin","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2113","name":"Spherocylindr 7.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":549.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63285","name":"Bx/exc idrl imed lesn cervl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, cervical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29200","name":"Strapping thorax","description":"Strapping; thorax","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3730.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1514.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77321","name":"Special teletx port plan","description":"Special teletherapy port plan, particles, hemibody, total body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3265","name":"Injection torsemide 10 mg/ml","description":"Injection, torsemide, 10 mg/ml","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86243","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55200","name":"Incision of sperm duct","description":"Vasotomy, cannulization with or without incision of vas, unilateral or bilateral (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2520","name":"Th/wght bear quad-lat brim c","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, custom fitted","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"L6580","name":"Wrist/elbow bowden cable mol","description":"Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"J9265","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28264","name":"Release of midfoot joint","description":"Capsulotomy, midtarsal (eg, heyman type procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":868.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"43605","name":"Biopsy of stomach","description":"Biopsy of stomach, by laparotomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86023","name":"Immunoglobulin assay","description":"Antibody identification; platelet associated immunoglobulin assay","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"78007","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5450","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"20962","name":"Other bone graft microvasc","description":"Bone graft with microvascular anastomosis; other than fibula, iliac crest, or metatarsal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4314","name":"Cath w/drainage 2-way latex","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77086","name":"Vrt fracture assmt via dxa","description":"Vertebral fracture assessment via dual-energy x-ray absorptiometry (dxa)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["26"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21070","name":"Remove coronoid process","description":"Coronoidectomy (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"56633","name":"Vulvectomy radical complete","description":"Vulvectomy, radical, complete;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93732","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2266.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"87299","name":"Antibody detection nos if","description":"Infectious agent antigen detection by immunofluorescent technique; not otherwise specified, each organism","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"86161","name":"Complement/function activity","description":"Complement; functional activity, each component","date_of_service":"2026-05-10","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":"L8684","name":"Radiof trsmtr implt scrl neu","description":"Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24345","name":"Repr elbw med ligmnt w/tissu","description":"Repair medial collateral ligament, elbow, with local tissue","date_of_service":"2026-05-10","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":"A4427","name":"Ost pch drain/barr lk flng/f","description":"Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each","date_of_service":"2026-05-10","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":"63268","name":"Excise intrspinl lesion scrl","description":"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; sacral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1484.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","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":"61541","name":"Incision of brain tissue","description":"Craniotomy with elevation of bone flap; for transection of corpus callosum","date_of_service":"2026-05-10","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":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":663.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84376","name":"Sugars single qual","description":"Sugars (mono-, di-, and oligosaccharides); single qualitative, each specimen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"95951","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":873.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":587.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82375","name":"Assay carboxyhb quant","description":"Carboxyhemoglobin; quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4011","name":"Cast sup sht arm ped plaster","description":"Cast supplies, short arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"E0236","name":"Pump for water circulating p","description":"Pump for water circulating pad","date_of_service":"2026-05-10","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":"61340","name":"Subtemporal cranial dcmprn","description":"Subtemporal cranial decompression (pseudotumor cerebri, slit ventricle syndrome)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"27315","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"88188","name":"Flowcytometry/read 9-15","description":"Flow cytometry, interpretation; 9 to 15 markers","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00630","name":"Anes px lumbar region nos","description":"Anesthesia for procedures in lumbar region; not otherwise specified","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-10","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":"01963","name":"Anes cesarean hysterectomy","description":"Anesthesia for cesarean hysterectomy without any labor analgesia/anesthesia care","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84586","name":"Assay of vip","description":"Vasoactive intestinal peptide (vip)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KF"]}],"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":"2026-05-10","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":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26860","name":"Fusion of finger joint","description":"Arthrodesis, interphalangeal joint, with or without internal fixation;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1369.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"21282","name":"Lateral canthopexy","description":"Lateral canthopexy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"32666","name":"Thoracoscopy w/wedge resect","description":"Thoracoscopy, surgical; with therapeutic wedge resection (eg, mass, nodule), initial unilateral","date_of_service":"2026-05-10","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":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-05-10","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":"01120","name":"Anes px on bony pelvis","description":"Anesthesia for procedures on bony pelvis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"00842","name":"Anes iper px amniocentesis","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; amniocentesis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"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":"2026-05-10","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":"A9537","name":"Tc99m mebrofenin","description":"Technetium tc-99m mebrofenin, diagnostic, per study dose, up to 15 millicuries","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"64647","name":"Chemodenerv trunk musc 6/>","description":"Chemodenervation of trunk muscle(s); 6 or more muscles","date_of_service":"2026-05-10","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":"35207","name":"Rpr bld vsl dir hand finger","description":"Repair blood vessel, direct; hand, finger","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":856.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85536","name":"Iron stain peripheral blood","description":"Iron stain, peripheral blood","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75558","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9395","name":"Injection, fulvestrant","description":"Injection, fulvestrant, 25 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"G2012","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":689.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23800","name":"Arthrodesis glenohumeral jt","description":"Arthrodesis, glenohumeral joint;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"26455","name":"Incision of finger tendon","description":"Tenotomy, flexor, finger, open, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"Q4049","name":"Finger splint, static","description":"Finger splint, static","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1422.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":851.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99195","name":"Phlebotomy","description":"Phlebotomy, therapeutic (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6648","name":"Ext pwrd shlder lock/unlock","description":"Upper extremity addition, shoulder lock mechanism, external powered actuator","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","date_of_service":"2026-05-10","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":"77262","name":"Ther radiology tx plng intrm","description":"Therapeutic radiology treatment planning; intermediate","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5410","name":"Postop dsg bk ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77280","name":"Ther rad simulaj field smpl","description":"Therapeutic radiology simulation-aided field setting; simple","date_of_service":"2026-05-10","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":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8659","name":"Interphalangeal joint repl","description":"Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","date_of_service":"2026-05-10","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":"25150","name":"Partial removal of ulna","description":"Partial excision (craterization, saucerization, or diaphysectomy) of bone (eg, for osteomyelitis); ulna","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29916","name":"Hip arthro w/labral repair","description":"Arthroscopy, hip, surgical; with labral repair","date_of_service":"2026-05-10","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":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","date_of_service":"2026-05-10","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":"87140","name":"Culture type immunofluoresc","description":"Culture, typing; immunofluorescent method, each antiserum","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":890.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6670","name":"Hook to hand cable adapter","description":"Upper extremity addition, hook to hand, cable adapter","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28118","name":"Removal of heel bone","description":"Ostectomy, calcaneus;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":878.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"68360","name":"Revise eyelid lining","description":"Conjunctival flap; bridge or partial (separate procedure)","date_of_service":"2026-05-10","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":"76120","name":"Cine/video x-rays","description":"Cineradiography/videoradiography, except where specifically included","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3071.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3765","name":"Ewhfo rigid w/o jnts cf","description":"Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"96155","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"88388","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"95868","name":"Ndl emg cranial nrv musc bi","description":"Needle electromyography; cranial nerve supplied muscles, bilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57550","name":"Removal of residual cervix","description":"Excision of cervical stump, vaginal approach;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":894.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"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":"2026-05-10","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":"41015","name":"Drainage of mouth lesion","description":"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; sublingual","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"97012","name":"Mechanical traction therapy","description":"Application of a modality to 1 or more areas; traction, mechanical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L0454","name":"Tlso trnk sj-t9 pre cst","description":"Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefa","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2471.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"75993","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":677.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":763.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95953","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"75562","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76120","name":"Cine/video x-rays","description":"Cineradiography/videoradiography, except where specifically included","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"27780","name":"Treatment of fibula fracture","description":"Closed treatment of proximal fibula or shaft fracture; without manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"35516","name":"Art byp grft subclav-axilary","description":"Bypass graft, with vein; subclavian-axillary","date_of_service":"2026-05-10","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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85557","name":"Rbc osmotic fragility","description":"Osmotic fragility, rbc; incubated","date_of_service":"2026-05-10","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":"72128","name":"Ct chest spine w/o dye","description":"Computed tomography, thoracic spine; without contrast material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64708","name":"Revise arm/leg nerve","description":"Neuroplasty, major peripheral nerve, arm or leg, open; other than specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":542.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1005","name":"Tension based scoliosis orth","description":"Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"21325","name":"Open tx nose fx uncomplicatd","description":"Open treatment of nasal fracture; uncomplicated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0830","name":"Halo cerv into milwaukee typ","description":"Halo procedure, cervical halo incorporated into milwaukee type orthosis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92950","name":"Heart/lung resuscitation cpr","description":"Cardiopulmonary resuscitation (eg, in cardiac arrest)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20615","name":"Treatment of bone cyst","description":"Aspiration and injection for treatment of bone cyst","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J9182","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51845","name":"Repair bladder neck","description":"Abdomino-vaginal vesical neck suspension, with or without endoscopic control (eg, stamey, raz, modified pereyra)","date_of_service":"2026-05-10","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":"19328","name":"Rmvl intact breast implant","description":"Removal of intact breast implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2126.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92984","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L2600","name":"Hip clevis/thrust bearing fr","description":"Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KF"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2058.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3927","name":"Fo pip dip no jt spr pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1180","name":"Wheelchair amputee w/ foot r","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable footrests","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"35905","name":"Excision graft thorax","description":"Excision of infected graft; thorax","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58541","name":"Lsh uterus 250 g or less","description":"Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33803","name":"Div aberrant vsl w/reanast","description":"Division of aberrant vessel (vascular ring); with reanastomosis","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"97024","name":"Diathermy eg microwave","description":"Application of a modality to 1 or more areas; diathermy (eg, microwave)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"01916","name":"Anes dx arteriography/vngrph","description":"Anesthesia for diagnostic arteriography/venography","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2291","name":"Planar back for ped size wc","description":"Back, planar, for pediatric size wheelchair including fixed attaching hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1673.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"91034","name":"Gastroesophageal reflux test","description":"Esophagus, gastroesophageal reflux test; with nasal catheter ph electrode(s) placement, recording, analysis and interpretation","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"86320","name":"Serum immunoelectrophoresis","description":"Immunoelectrophoresis; serum","date_of_service":"2026-05-10","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":"35472","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67906","name":"Repair eyelid defect","description":"Repair of blepharoptosis; superior rectus technique with fascial sling (includes obtaining fascia)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2599","name":"Sgd accessory noc","description":"Accessory for speech generating device, not otherwise classified","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1311.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"27664","name":"Repair of leg tendon each","description":"Repair, extensor tendon, leg; primary, without graft, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","date_of_service":"2026-05-10","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":"36450","name":"Bld exchange truj newborn","description":"Exchange transfusion, blood; newborn","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"46715","name":"Rep perf anoper fistu","description":"Repair of low imperforate anus; with anoperineal fistula (cut-back procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0968","name":"Wheelchair commode seat","description":"Commode seat, wheelchair","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"82380","name":"Assay of carotene","description":"Carotene","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5703","name":"Symes ankle w/o (sach) foot","description":"Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1393.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","date_of_service":"2026-05-10","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":"L1060","name":"Thoracic pad","description":"Addition to ctlso or scoliosis orthosis, thoracic pad","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-10","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":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-10","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":"E8000","name":"Posterior gait trainer","description":"Gait trainer, pediatric size, posterior support, includes all accessories and components","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44397","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78647","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82136","name":"Amino acids quant 2-5","description":"Amino acids, 2 to 5 amino acids, quantitative, each specimen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0300","name":"Enclosed ped crib hosp grade","description":"Pediatric crib, hospital grade, fully enclosed, with or without top enclosure","date_of_service":"2026-05-10","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":"J0770","name":"Colistimethate sodium inj","description":"Injection, colistimethate sodium, up to 150 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4575","name":"Hyperbaric o2 chamber disps","description":"Topical hyperbaric oxygen chamber, disposable","date_of_service":"2026-05-10","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":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"43611","name":"Excision of stomach lesion","description":"Excision, local; malignant tumor of stomach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1018.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74740","name":"X-ray female genital tract","description":"Hysterosalpingography, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0358","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"36512","name":"Apheresis rbc","description":"Therapeutic apheresis; for red blood cells","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","date_of_service":"2026-05-10","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":"L3660","name":"So 8 ab rstr can/web pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"41826","name":"Excision of gum lesion","description":"Excision of lesion or tumor (except listed above), dentoalveolar structures; with simple repair","date_of_service":"2026-05-10","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":"49020","name":"Drainage abdom abscess open","description":"Drainage of peritoneal abscess or localized peritonitis, exclusive of appendiceal abscess, open","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-05-10","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":"E0786","name":"Implantable pump replacement","description":"Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KF"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":474.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"56625","name":"Vulvectomy simple complete","description":"Vulvectomy simple; complete","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82608","name":"B-12 binding capacity","description":"Cyanocobalamin (vitamin b-12); unsaturated binding capacity","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"E1825","name":"Adjust finger ext & flex dev","description":"Dynamic adjustable finger extension and flexion device, includes soft interface material","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J0713","name":"Inj ceftazidime per 500 mg","description":"Injection, ceftazidime, per 500 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70545","name":"Mr angiography head w/dye","description":"Magnetic resonance angiography, head; with contrast material(s)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":426.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-10","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":"71111","name":"X-ray exam ribs/chest4/> vws","description":"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":931.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27280","name":"Arthr si jt opn b1grf instrm","description":"Arthrodesis, sacroiliac joint, open, includes obtaining bone graft, including instrumentation, when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1430","name":"Ethanolamine oleate 100 mg","description":"Injection, ethanolamine oleate, 100 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"84153","name":"Assay of psa total","description":"Prostate specific antigen (psa); total","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0604","name":"Hosp grade elec breast pump","description":"Breast pump, hospital grade, electric (ac and / or dc), any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2530.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"J2010","name":"Lincomycin injection","description":"Injection, lincomycin hcl, up to 300 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1814.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"82787","name":"Igg 1 2 3 or 4 each","description":"Gammaglobulin (immunoglobulin); immunoglobulin subclasses (eg, igg1, 2, 3, or 4), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"90813","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46935","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4594","name":"Neuromod adj rehab mouthpie","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, mouthpiece each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0734","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55700","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2370","name":"Patten bottom","description":"Addition to lower extremity, patten bottom","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35879","name":"Revise graft w/vein","description":"Revision, lower extremity arterial bypass, without thrombectomy, open; with vein patch angioplasty","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"38562","name":"Removal pelvic lymph nodes","description":"Limited lymphadenectomy for staging (separate procedure); pelvic and para-aortic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84140","name":"Assay of pregnenolone","description":"Pregnenolone","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.16,"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-10","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":"70547","name":"Mr angiography neck w/o dye","description":"Magnetic resonance angiography, neck; without contrast material(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00916","name":"Anes trurl px rescj bleeding","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); post-transurethral resection bleeding","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5795","name":"Exoskel hip ultra-light mate","description":"Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"68420","name":"I&d lacrimal sac","description":"Incision, drainage of lacrimal sac (dacryocystotomy or dacryocystostomy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":870.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"43820","name":"Gastrojejunostomy wo vagotmy","description":"Gastrojejunostomy; without vagotomy","date_of_service":"2026-05-10","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":"86694","name":"Herpes simplex nes antbdy","description":"Antibody; herpes simplex, non-specific type test","date_of_service":"2026-05-10","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":"00124","name":"Anes px ear otoscopy","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; otoscopy","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5685","name":"Below knee sus/seal sleeve","description":"Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KC"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33230","name":"Insrt pulse gen w/dual leads","description":"Insertion of implantable defibrillator pulse generator only; with existing dual leads","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83914","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23150","name":"Removal of humerus lesion","description":"Excision or curettage of bone cyst or benign tumor of proximal humerus;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":758.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"76941","name":"Echo guide for transfusion","description":"Ultrasonic guidance for intrauterine fetal transfusion or cordocentesis, imaging supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"35901","name":"Excision graft neck","description":"Excision of infected graft; neck","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":660.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78201","name":"Liver imaging static only","description":"Liver imaging; static only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46050","name":"I&d perianal abscess supfc","description":"Incision and drainage, perianal abscess, superficial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1170","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45330","name":"Diagnostic sigmoidoscopy","description":"Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28635","name":"Treat toe dislocation","description":"Closed treatment of metatarsophalangeal joint dislocation; requiring anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3968","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"80500","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"C1788","name":"Port, indwelling, imp","description":"Port, indwelling (implantable)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2304","name":"Lens sphcy trifocal 4.0/2.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 2.25-4.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":907.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":652.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97113","name":"Aquatic therapy/exercises","description":"Therapeutic procedure, 1 or more areas, each 15 minutes; aquatic therapy with therapeutic exercises","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","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":"35400","name":"Angioscopy","description":"Angioscopy (noncoronary vessels or grafts) during therapeutic intervention (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP21","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0648","name":"Lso sag r an/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1190.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":632.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99323","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1161.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0655","name":"Pneumatic appliance half arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half arm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4020","name":"Replace quadlat socket brim","description":"Replace quadrilateral socket brim, molded to patient model","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":512.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00873","name":"Anes lithotrp esw wo wtr bth","description":"Anesthesia for lithotripsy, extracorporeal shock wave; without water bath","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-10","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":"62318","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"92341","name":"Fit spectacles bifocal","description":"Fitting of spectacles, except for aphakia; bifocal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82742","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":675.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"74450","name":"X-ray urethra/bladder","description":"Urethrocystography, retrograde, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"48155","name":"Removal of pancreas","description":"Pancreatectomy, total","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8702","name":"Ewhf s/d uprt micro sensor","description":"Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["KN"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26590","name":"Repair finger deformity","description":"Repair macrodactylia, each digit","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2208","name":"Lens sphcy bifocal 4.25-7/2.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1072.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83718","name":"Assay of lipoprotein","description":"Lipoprotein, direct measurement; high density cholesterol (hdl cholesterol)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29863","name":"Hip arthr0 w/synovectomy","description":"Arthroscopy, hip, surgical; with synovectomy","date_of_service":"2026-05-10","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":"V2700","name":"Balance lens","description":"Balance lens, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","date_of_service":"2026-05-10","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":"76981","name":"Use parenchyma","description":"Ultrasound, elastography; parenchyma (eg, organ)","date_of_service":"2026-05-10","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":"E1038","name":"Transport chair pt wt<=300lb","description":"Transport chair, adult size, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":530.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"38500","name":"Biopsy/removal lymph nodes","description":"Biopsy or excision of lymph node(s); open, superficial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78215","name":"Lvr&spleen img static only","description":"Liver and spleen imaging; static only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1845.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2975.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1087.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"27202","name":"Treat tail bone fracture","description":"Open treatment of coccygeal fracture","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1163.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-10","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":"77293","name":"Respirator motion mgmt simul","description":"Respiratory motion management simulation (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92120","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"70190","name":"X-ray exam of eye sockets","description":"Radiologic examination; optic foramina","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"94200","name":"Lung function test (mbc/mvv)","description":"Maximum breathing capacity, maximal voluntary ventilation","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"78457","name":"Venous thrombosis imaging","description":"Venous thrombosis imaging, venogram; unilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0626","name":"Lo sag rig pnl stays pre cst","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","date_of_service":"2026-05-10","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":"L5250","name":"Hip canad sing axi cons fric","description":"Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27788","name":"Treatment of ankle fracture","description":"Closed treatment of distal fibular fracture (lateral malleolus); with manipulation","date_of_service":"2026-05-10","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":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93970","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26685","name":"Treat hand dislocation","description":"Open treatment of carpometacarpal dislocation, other than thumb; includes internal fixation, when performed, each joint","date_of_service":"2026-05-10","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":"24362","name":"Reconstruct elbow joint","description":"Arthroplasty, elbow; with implant and fascia lata ligament reconstruction","date_of_service":"2026-05-10","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":"49561","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":987.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31294","name":"Nsl/sins ndsc surg on dcmprn","description":"Nasal/sinus endoscopy, surgical, with optic nerve decompression","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"26991","name":"Drainage of pelvis bursa","description":"Incision and drainage, pelvis or hip joint area; infected bursa","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1810","name":"Ko elastic with joints","description":"Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77523","name":"Proton trmt intermediate","description":"Proton treatment delivery; intermediate","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":703.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27005","name":"Tenotomy hip flexor open","description":"Tenotomy, hip flexor(s), open (separate procedure)","date_of_service":"2026-05-10","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":"93990","name":"Doppler flow testing","description":"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow)","date_of_service":"2026-05-10","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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69666","name":"Repair middle ear structures","description":"Repair oval window fistula","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6675","name":"Harness figure of 8 sing con","description":"Upper extremity addition, harness, (e.g., figure of eight type), single cable design","date_of_service":"2026-05-10","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":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"78457","name":"Venous thrombosis imaging","description":"Venous thrombosis imaging, venogram; unilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["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":"2026-05-10","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":"00844","name":"Anes iper px abdmnprnl rescj","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; abdominoperineal resection","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"78103","name":"Bone marrow imaging mult","description":"Bone marrow imaging; multiple areas","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1514.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42200","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate, soft and/or hard palate only","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":528.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1417.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5585","name":"Prep ak ischial open end","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1334.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"77370","name":"Radiation physics consult","description":"Special medical radiation physics consultation","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3730","name":"Forearm/arm cuffs ext/flex a","description":"Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":536.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KL","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33120","name":"Exc icar tum resc w/card byp","description":"Excision of intracardiac tumor, resection with cardiopulmonary bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1821.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46320","name":"Removal of hemorrhoid clot","description":"Excision of thrombosed hemorrhoid, external","date_of_service":"2026-05-10","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":"46505","name":"Chemodenervation anal musc","description":"Chemodenervation of internal anal sphincter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63278","name":"Bx/exc xdrl spine lesn scrl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, sacral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-05-10","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":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35537","name":"Art byp grft aortoiliac","description":"Bypass graft, with vein; aortoiliac","date_of_service":"2026-05-10","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":"01961","name":"Anes cesarean delivery only","description":"Anesthesia for cesarean delivery only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24136","name":"Sequestrectomy radial h/n","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), radial head or neck","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"38243","name":"Transplj hematopoietic boost","description":"Hematopoietic progenitor cell (hpc); hpc boost","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37660","name":"Ligation common iliac vein","description":"Ligation of common iliac vein","date_of_service":"2026-05-10","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":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3067.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":763.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0720","name":"Chloramphenicol sodium injec","description":"Injection, chloramphenicol sodium succinate, up to 1 gm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-10","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":"24152","name":"Rad resection tum radial h/n","description":"Radical resection of tumor, radial head or neck","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":874.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-10","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":"27295","name":"Amputation of leg at hip","description":"Disarticulation of hip","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"29861","name":"Hip arthro w/fb removal","description":"Arthroscopy, hip, surgical; with removal of loose body or foreign body","date_of_service":"2026-05-10","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":"33212","name":"Insert pulse gen sngl lead","description":"Insertion of pacemaker pulse generator only; with existing single lead","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J0380","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0564T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"B9002","name":"Enter nutr inf pump any type","description":"Enteral nutrition infusion pump, any type","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0205","name":"Heat lamp with stand","description":"Heat lamp, with stand, includes bulb, or infrared element","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-05-10","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":"L1685","name":"Post-op hip abduct custom fa","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79445","name":"Nuclear rx intra-arterial","description":"Radiopharmaceutical therapy, by intra-arterial particulate administration","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"15366","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"37207","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"78258","name":"Esophageal motility","description":"Esophageal motility","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49570","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0986","name":"Man w/c powr assist syst","description":"Manual wheelchair accessory, power assist system","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19290","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31515","name":"Laryngoscopy for aspiration","description":"Laryngoscopy direct, with or without tracheoscopy; for aspiration","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J1364","name":"Erythro lactobionate /500 mg","description":"Injection, erythromycin lactobionate, per 500 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","date_of_service":"2026-05-10","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":"G0354","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21029","name":"Contour of face bone lesion","description":"Removal by contouring of benign tumor of facial bone (eg, fibrous dysplasia)","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"92596","name":"Ear protector evaluation","description":"Ear protector attenuation measurements","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1947.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"35483","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1905.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1031","name":"Rollabout chair with casters","description":"Rollabout chair, any and all types with casters 5 or greater","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78607","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6574","name":"Custom gradient sleev/glov","description":"Gradient compression arm sleeve and glove combination, custom, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"46020","name":"Placement of seton","description":"Placement of seton","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"10040","name":"Extraction","description":"Extraction (eg, marsupialization, opening or removal of multiple milia, comedones, cysts, pustules)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82728","name":"Assay of ferritin","description":"Ferritin","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27695","name":"Repair of ankle ligament","description":"Repair, primary, disrupted ligament, ankle; collateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43255","name":"Egd control bleeding any","description":"Esophagogastroduodenoscopy, flexible, transoral; with control of bleeding, any method","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L4386","name":"Non-pneum walk boot pre cst","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","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":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69745","name":"Repair facial nerve","description":"Suture facial nerve, intratemporal, with or without graft or decompression; including medial to geniculate ganglion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1002.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99170","name":"Anogenital exam child w imag","description":"Anogenital examination, magnified, in childhood for suspected trauma, including image recording when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0560","name":"Humidifier supplemental w/ i","description":"Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"96450","name":"Chemotherapy into cns","description":"Chemotherapy administration, into cns (eg, intrathecal), requiring and including spinal puncture","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"20527","name":"Njx nzm palmar fascial cord","description":"Injection, enzyme (eg, collagenase), palmar fascial cord (ie, dupuytrens contracture)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86804","name":"Hep c ab test confirm","description":"Hepatitis c antibody; confirmatory test (eg, immunoblot)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36660","name":"Insertion catheter artery","description":"Catheterization, umbilical artery, newborn, for diagnosis or therapy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21620","name":"Ostectomy sternum partial","description":"Ostectomy of sternum, partial","date_of_service":"2026-05-10","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":"26011","name":"Drainage of finger abscess","description":"Drainage of finger abscess; complicated (eg, felon)","date_of_service":"2026-05-10","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":"41153","name":"Tongue mouth neck surgery","description":"Glossectomy; composite procedure with resection floor of mouth, with suprahyoid neck dissection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2293.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3411","name":"Thiamine hcl 100 mg","description":"Injection, thiamine hcl, 100 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0433","name":"Portable liquid oxygen sys","description":"Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":714.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"96409","name":"Chemo iv push sngl drug","description":"Chemotherapy administration; intravenous, push technique, single or initial substance/drug","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78261","name":"Gastric mucosa imaging","description":"Gastric mucosa imaging","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88355","name":"M/phmtrc alys skeletal musc","description":"Morphometric analysis; skeletal muscle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1729.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"85270","name":"Clot factor xi pta","description":"Clotting; factor xi (pta)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"23440","name":"Remove/transplant tendon","description":"Resection or transplantation of long tendon of biceps","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":937.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21100","name":"Maxillofacial fixation","description":"Application of halo type appliance for maxillofacial fixation, includes removal (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26255","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"56631","name":"Vlvctmy rad prtl uni lymphad","description":"Vulvectomy, radical, partial; with unilateral inguinofemoral lymphadenectomy","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31000","name":"Irrigation maxillary sinus","description":"Lavage by cannulation; maxillary sinus (antrum puncture or natural ostium)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"64566","name":"Neuroeltrd stim post tibial","description":"Posterior tibial neurostimulation, percutaneous needle electrode, single treatment, includes programming","date_of_service":"2026-05-10","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":"86717","name":"Leishmania antibody","description":"Antibody; leishmania","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86360","name":"T cell absolute count/ratio","description":"T cells; absolute cd4 and cd8 count, including ratio","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84255","name":"Assay of selenium","description":"Selenium","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0628","name":"Lso flex no ri stays pre ots","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75872","name":"Vein x-ray skull epidural","description":"Venography, epidural, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"28070","name":"Removal of foot joint lining","description":"Synovectomy; intertarsal or tarsometatarsal joint, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":610.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68110","name":"Exc les conjunctiva <1 cm","description":"Excision of lesion, conjunctiva; up to 1 cm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J3140","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"83001","name":"Assay of gonadotropin (fsh)","description":"Gonadotropin; follicle stimulating hormone (fsh)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2775.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6146.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84157","name":"Assay of protein other","description":"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid)","date_of_service":"2026-05-10","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":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92228","name":"Img rta detc/mntr ds phy/qhp","description":"Imaging of retina for detection or monitoring of disease; with remote physician or other qualified health care professional interpretation and report, unilateral or bilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"21121","name":"Geniop sldg osteot 1","description":"Genioplasty; sliding osteotomy, single piece","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26477","name":"Tendon shortening","description":"Shortening of tendon, extensor, hand or finger, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76770","name":"Us exam abdo back wall comp","description":"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"23455","name":"Repair shoulder capsule","description":"Capsulorrhaphy, anterior; with labral repair (eg, bankart procedure)","date_of_service":"2026-05-10","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":"83890","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"27831","name":"Treat lower leg dislocation","description":"Closed treatment of proximal tibiofibular joint dislocation; requiring anesthesia","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"33400","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1925.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3913","name":"Hfo w/o joints cf","description":"Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":"11721","name":"Debride nail 6 or more","description":"Debridement of nail(s) by any method(s); 6 or more","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82438","name":"Assay other fluid chlorides","description":"Chloride; other source","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1639.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85348","name":"Coagulation time otr method","description":"Coagulation time; other methods","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86157","name":"Cold agglutinin titer","description":"Cold agglutinin; titer","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"J3230","name":"Chlorpromazine hcl injection","description":"Injection, chlorpromazine hcl, up to 50 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74775","name":"X-ray exam of perineum","description":"Perineogram (eg, vaginogram, for sex determination or extent of anomalies)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83909","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"76101","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49322","name":"Laparoscopy aspiration","description":"Laparoscopy, surgical; with aspiration of cavity or cyst (eg, ovarian cyst) (single or multiple)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28111","name":"Part removal of metatarsal","description":"Ostectomy, complete excision; first metatarsal head","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43228","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":506.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2036.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32096","name":"Open wedge/bx lung infiltr","description":"Thoracotomy, with diagnostic biopsy(ies) of lung infiltrate(s) (eg, wedge, incisional), unilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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","AV","AU","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"68400","name":"I&d lacrimal gland","description":"Incision, drainage of lacrimal gland","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35381","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1156.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77310","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"26045","name":"Release palm contracture","description":"Fasciotomy, palmar (eg, dupuytrens contracture); open, partial","date_of_service":"2026-05-10","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":"43830","name":"Gstrst open wo constj tube","description":"Gastrostomy, open; without construction of gastric tube (eg, stamm procedure) (separate procedure)","date_of_service":"2026-05-10","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":"64771","name":"Sever cranial nerve","description":"Transection or avulsion of other cranial nerve, extradural","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":506.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87088","name":"Urine bacteria culture","description":"Culture, bacterial; with isolation and presumptive identification of each isolate, urine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93501","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88160","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; screening and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15340","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47564","name":"Laparo cholecystectomy/explr","description":"Laparoscopy, surgical; cholecystectomy with exploration of common duct","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":981.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29888","name":"Arthrs aid acl rpr/agmntj","description":"Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1207.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"76821","name":"Middle cerebral artery echo","description":"Doppler velocimetry, fetal; middle cerebral artery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1010","name":"Add pwr leg elevation","description":"Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"L5840","name":"Multi-axial knee/shin system","description":"Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2578.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27100","name":"Transfer of abdominal muscle","description":"Transfer external oblique muscle to greater trochanter including fascial or tendon extension (graft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":980.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2447.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0361","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":648.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-10","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":"88154","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"50130","name":"Pyelotomy w/removal calculus","description":"Pyelotomy; with removal of calculus (pyelolithotomy, pelviolithotomy, including coagulum pyelolithotomy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1119.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1031","name":"Rollabout chair with casters","description":"Rollabout chair, any and all types with casters 5 or greater","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33992","name":"Rmvl perq left heart vad","description":"Removal of percutaneous left heart ventricular assist device, arterial or arterial and venous cannula(s), at separate and distinct session from insertion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64820","name":"Sympathectomy digital artery","description":"Sympathectomy; digital arteries, each digit","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"B9000","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42505","name":"Repair salivary duct","description":"Plastic repair of salivary duct, sialodochoplasty; secondary or complicated","date_of_service":"2026-05-10","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":"52290","name":"Cystoscopy and treatment","description":"Cystourethroscopy; with ureteral meatotomy, unilateral or bilateral","date_of_service":"2026-05-10","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":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5617","name":"Ak/bk self-aligning unit ea","description":"Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24470","name":"Hemiepiphyseal arrest","description":"Hemiepiphyseal arrest (eg, cubitus varus or valgus, distal humerus)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":821.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6026","name":"Part hand myo exclu term dev","description":"Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device, excludes terminal device(s)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"62256","name":"Remove brain cavity shunt","description":"Removal of complete cerebrospinal fluid shunt system; without replacement","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"87271","name":"Cytomegalovirus dfa","description":"Infectious agent antigen detection by immunofluorescent technique; cytomegalovirus, direct fluorescent antibody (dfa)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27170","name":"Repair/graft femur head/neck","description":"Bone graft, femoral head, neck, intertrochanteric or subtrochanteric area (includes obtaining bone graft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1373.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J0850","name":"Cytomegalovirus imm iv /vial","description":"Injection, cytomegalovirus immune globulin intravenous (human), per vial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":672.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4768.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":619.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"78650","name":"Csf leakage imaging","description":"Cerebrospinal fluid leakage detection and localization","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0861","name":"Halo repl liner/interface","description":"Addition to halo procedure, replacement liner/interface material","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"99186","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23334","name":"Shoulder prosthesis removal","description":"Removal of prosthesis, includes debridement and synovectomy when performed; humeral or glenoid component","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1172.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5280","name":"Hemipelvect canad sing axis","description":"Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78011","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1598.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"36835","name":"Insertion thomas shunt","description":"Insertion of thomas shunt (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1667.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G6016","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4583.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E1840","name":"Adj shoulder ext/flex device","description":"Dynamic adjustable shoulder flexion / abduction / rotation device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"C1730","name":"Cath, ep, 19 or few elect","description":"Catheter, electrophysiology, diagnostic, other than 3d mapping (19 or fewer electrodes)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29821","name":"Sho arthrs srg compl synvct","description":"Arthroscopy, shoulder, surgical; synovectomy, complete","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":723.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46230","name":"Removal of anal tags","description":"Excision of multiple external papillae or tags, anus","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":661.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"67825","name":"Revise eyelashes","description":"Correction of trichiasis; epilation by other than forceps (eg, by electrosurgery, cryotherapy, laser surgery)","date_of_service":"2026-05-10","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":"57287","name":"Revise/remove sling repair","description":"Removal or revision of sling for stress incontinence (eg, fascia or synthetic)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82979","name":"Assay rbc glutathione","description":"Glutathione reductase, rbc","date_of_service":"2026-05-10","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":"59030","name":"Fetal scalp blood sampling","description":"Fetal scalp blood sampling","date_of_service":"2026-05-10","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":"78272","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3071.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"50684","name":"Injection for ureter x-ray","description":"Injection procedure for ureterography or ureteropyelography through ureterostomy or indwelling ureteral catheter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","date_of_service":"2026-05-10","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":"J0550","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"27161","name":"Incision of neck of femur","description":"Osteotomy, femoral neck (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33535","name":"Cabg arterial three","description":"Coronary artery bypass, using arterial graft(s); 3 coronary arterial grafts","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82040","name":"Assay of serum albumin","description":"Albumin; serum, plasma or whole blood","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L3965","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92270","name":"Electro-oculography w/i&r","description":"Electro-oculography with interpretation and report","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29863","name":"Hip arthr0 w/synovectomy","description":"Arthroscopy, hip, surgical; with synovectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5964","name":"Above knee flex cover system","description":"Addition, endoskeletal system, above knee, flexible protective outer surface covering system","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"19369","name":"Brst rcnstj 2 pdcl tram flap","description":"Breast reconstruction; with bipedicled transverse rectus abdominis myocutaneous (tram) flap","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2379.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42326","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1257.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51792","name":"Urinary reflex study","description":"Stimulus evoked response (eg, measurement of bulbocavernosus reflex latency time)","date_of_service":"2026-05-10","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":"80101","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E0200","name":"Heat lamp without stand","description":"Heat lamp, without stand (table model), includes bulb, or infrared element","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"33514","name":"Cabg vein five","description":"Coronary artery bypass, vein only; 5 coronary venous grafts","date_of_service":"2026-05-10","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":"84591","name":"Assay of nos vitamin","description":"Vitamin, not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70130","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; complete, minimum of 3 views per side","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-10","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":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43271","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7026","name":"Replace chst cmprss sys hose","description":"High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33474","name":"Revision of pulmonary valve","description":"Valvotomy, pulmonary valve, open heart, with cardiopulmonary bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"34805","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1474.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"00522","name":"Anes clsd ch px ndl bx pleur","description":"Anesthesia for closed chest procedures; needle biopsy of pleura","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"36145","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23395","name":"Muscle transfer shoulder/arm","description":"Muscle transfer, any type, shoulder or upper arm; single","date_of_service":"2026-05-10","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":"J2355","name":"Oprelvekin injection","description":"Injection, oprelvekin, 5 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"59410","name":"Obstetrical care","description":"Vaginal delivery only (with or without episiotomy and/or forceps); including postpartum care","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27562","name":"Treat kneecap dislocation","description":"Closed treatment of patellar dislocation; requiring anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54120","name":"Partial removal of penis","description":"Amputation of penis; partial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":670.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","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":"84166","name":"Protein e-phoresis/urine/csf","description":"Protein; electrophoretic fractionation and quantitation, other fluids with concentration (eg, urine, csf)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"63709","name":"Repair spinal fluid leakage","description":"Repair of dural/cerebrospinal fluid leak or pseudomeningocele, with laminectomy","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27193","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1232.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"26037","name":"Decompress fingers/hand","description":"Decompressive fasciotomy, hand (excludes 26035)","date_of_service":"2026-05-10","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":"28495","name":"Treat big toe fracture","description":"Closed treatment of fracture great toe, phalanx or phalanges; with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"J9201","name":"In gemcitabine hcl nos 200mg","description":"Injection, gemcitabine hydrochloride, not otherwise specified, 200 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1816.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E1238","name":"Fld ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, folding, adjustable, without seating system","date_of_service":"2026-05-10","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":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"42836","name":"Removal of adenoids","description":"Adenoidectomy, secondary; age 12 or over","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"99354","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"J3364","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"84155","name":"Assay of protein serum","description":"Protein, total, except by refractometry; serum, plasma or whole blood","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2106","name":"Spherocylinder 4.00d/>6.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21029","name":"Contour of face bone lesion","description":"Removal by contouring of benign tumor of facial bone (eg, fibrous dysplasia)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q0178","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81178","name":"Atxn1 gene detc abnor allele","description":"Atxn1 (ataxin 1) (eg, spinocerebellar ataxia) gene analysis, evaluation to detect abnormal (eg, expanded) alleles","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00796","name":"Anes iper upr abd lvr trnspl","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; liver transplant (recipient)","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31500","name":"Insert emergency airway","description":"Intubation, endotracheal, emergency procedure","date_of_service":"2026-05-10","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":"21087","name":"Impres&prep nasal prosth","description":"Impression and custom preparation; nasal prosthesis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27235","name":"Treat thigh fracture","description":"Percutaneous skeletal fixation of femoral fracture, proximal end, neck","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1081.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-10","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":"A6234","name":"Hydrocolld drg <=16 w/o bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26750","name":"Treat finger fracture each","description":"Closed treatment of distal phalangeal fracture, finger or thumb; without manipulation, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2059.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75958","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"Q0481","name":"Microprcsr cu elec vad, rep","description":"Microprocessor control unit for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"29440","name":"Adding walker to prev cast","description":"Adding walker to previously applied cast","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":384.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73501","name":"X-ray exam hip uni 1 view","description":"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view","date_of_service":"2026-05-10","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":"23530","name":"Optx strnclav dislc aqt/chrn","description":"Open treatment of sternoclavicular dislocation, acute or chronic;","date_of_service":"2026-05-10","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":"33514","name":"Cabg vein five","description":"Coronary artery bypass, vein only; 5 coronary venous grafts","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3906","name":"Who w/o joints cf","description":"Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-05-10","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":"64802","name":"Sympathectomy cervical","description":"Sympathectomy, cervical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93236","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00868","name":"Anes xtrprtl px rnl transpl","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; renal transplant (recipient)","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82436","name":"Assay of urine chloride","description":"Chloride; urine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78740","name":"Ureteral reflux study","description":"Ureteral reflux study (radiopharmaceutical voiding cystogram)","date_of_service":"2026-05-10","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":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82775","name":"Assay galactose transferase","description":"Galactose-1-phosphate uridyl transferase; quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78700","name":"Kidney imaging morphol","description":"Kidney imaging morphology;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":682.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"35459","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35510","name":"Art byp grft carotid-brchial","description":"Bypass graft, with vein; carotid-brachial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1552.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6252","name":"Absorpt drg >16 <=48 w/o bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64530","name":"N block inj celiac pelus","description":"Injection, anesthetic agent; celiac plexus, with or without radiologic monitoring","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"T4524","name":"Adult size brief/diaper xl","description":"Adult sized disposable incontinence product, brief/diaper, extra large, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L0629","name":"Lso flex w/rigid stays cust","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, custom","date_of_service":"2026-05-10","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":"30903","name":"Control of nosebleed","description":"Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method","date_of_service":"2026-05-10","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":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01500","name":"Anes px art lower leg nos","description":"Anesthesia for procedures on arteries of lower leg, including bypass graft; not otherwise specified","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":"L5632","name":"Symes type ptb brim design s","description":"Addition to lower extremity, symes type, ptb brim design socket","date_of_service":"2026-05-10","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":"G9141","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"56501","name":"Destroy vulva lesions sim","description":"Destruction of lesion(s), vulva; simple (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"78071","name":"Parathyrd planar w/wo subtrj","description":"Parathyroid planar imaging (including subtraction, when performed); with tomographic (spect)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"70120","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; less than 3 views per side","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26445","name":"Release hand/finger tendon","description":"Tenolysis, extensor tendon, hand or finger, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82735","name":"Assay of fluoride","description":"Fluoride","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"51940","name":"Correction of bladder defect","description":"Closure, exstrophy of bladder","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1862.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1634.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00864","name":"Anes xtrprt lwr abd tot cstc","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; total cystectomy","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":566.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0935","name":"Cont pas motion exercise dev","description":"Continuous passive motion exercise device for use on knee only","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"43262","name":"Endo cholangiopancreatograph","description":"Endoscopic retrograde cholangiopancreatography (ercp); with sphincterotomy/papillotomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26843","name":"Fusion of hand joint","description":"Arthrodesis, carpometacarpal joint, digit, other than thumb, each;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1763.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0762","name":"Trans elec jt stim dev sys","description":"Transcutaneous electrical joint stimulation device system, includes all accessories","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21248","name":"Reconstruction of jaw","description":"Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); partial","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"66220","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":680.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75891","name":"Vein x-ray liver","description":"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"78580","name":"Lung perfusion imaging","description":"Pulmonary perfusion imaging (eg, particulate)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"L0626","name":"Lo sag rig pnl stays pre cst","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"A4612","name":"Battery cables","description":"Battery cables; replacement for patient-owned ventilator","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"88380","name":"Microdissection laser","description":"Microdissection (ie, sample preparation of microscopically identified target); laser capture","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01202","name":"Anes arthroscopic px hip jt","description":"Anesthesia for arthroscopic procedures of hip joint","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4312","name":"Cath w/o bag 2-way silicone","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":480.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":938.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21070","name":"Remove coronoid process","description":"Coronoidectomy (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":754.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"32853","name":"Lung transplant double","description":"Lung transplant, double (bilateral sequential or en bloc); without cardiopulmonary bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3703.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"33218","name":"Repair lead pace-defib one","description":"Repair of single transvenous electrode, permanent pacemaker or implantable defibrillator","date_of_service":"2026-05-10","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":"67515","name":"Inject/treat eye socket","description":"Injection of medication or other substance into tenons capsule","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1815","name":"Adjust ankle ext & flex dev","description":"Dynamic adjustable ankle extension and flexion device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88400","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"78016","name":"Thyroid met imaging/studies","description":"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3315","name":"Triptorelin pamoate","description":"Injection, triptorelin pamoate, 3.75 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"43202","name":"Esophagoscopy flex biopsy","description":"Esophagoscopy, flexible, transoral; with biopsy, single or multiple","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0601","name":"Repl batt silver oxide 1.5 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65420","name":"Removal of eye lesion","description":"Excision or transposition of pterygium; without graft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74185","name":"Mra abd w or w/o cntrst","description":"Magnetic resonance angiography, abdomen, with or without contrast material(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":683.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":659.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43263","name":"Ercp sphincter pressure meas","description":"Endoscopic retrograde cholangiopancreatography (ercp); with pressure measurement of sphincter of oddi","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21248","name":"Reconstruction of jaw","description":"Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); partial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"85557","name":"Rbc osmotic fragility","description":"Osmotic fragility, rbc; incubated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"37225","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66680","name":"Repair iris & ciliary body","description":"Repair of iris, ciliary body (as for iridodialysis)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67316","name":"Revise two eye muscles","description":"Strabismus surgery, recession or resection procedure; 2 or more vertical muscles (excluding superior oblique)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0207","name":"Amifostine","description":"Injection, amifostine, 500 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01920","name":"Anes cardiac catheterization","description":"Anesthesia for cardiac catheterization including coronary angiography and ventriculography (not to include swan-ganz catheter)","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01829","name":"Anes dx arthroscopic px wrst","description":"Anesthesia for diagnostic arthroscopic procedures on the wrist","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0941","name":"Gravity assisted traction de","description":"Gravity assisted traction device, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2760","name":"Phentolaine mesylate inj","description":"Injection, phentolamine mesylate, up to 5 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28153","name":"Partial removal of toe","description":"Resection, condyle(s), distal end of phalanx, each toe","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55870","name":"Electroejaculation","description":"Electroejaculation","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"93544","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"20824","name":"Replantation thumb complete","description":"Replantation, thumb (includes carpometacarpal joint to mp joint), complete amputation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"0295T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25290","name":"Incise wrist/forearm tendon","description":"Tenotomy, open, flexor or extensor tendon, forearm and/or wrist, single, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1785","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"72265","name":"Myelography l-s spine","description":"Myelography, lumbosacral, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27860","name":"Fixation of ankle joint","description":"Manipulation of ankle under general anesthesia (includes application of traction or other fixation apparatus)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2508.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15852","name":"Dressing change not for burn","description":"Dressing change (for other than burns) under anesthesia (other than local)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1996.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":780.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57105","name":"Biopsy vaginal mucosa xtnsv","description":"Biopsy of vaginal mucosa; extensive, requiring suture (including cysts)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"39560","name":"Resect diaphragm simple","description":"Resection, diaphragm; with simple repair (eg, primary suture)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27235","name":"Treat thigh fracture","description":"Percutaneous skeletal fixation of femoral fracture, proximal end, neck","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4431","name":"Ost pch urine w barrier/tapv","description":"Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"27536","name":"Treat knee fracture","description":"Open treatment of tibial fracture, proximal (plateau); bicondylar, with or without internal fixation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27179","name":"Revise head/neck of femur","description":"Open treatment of slipped femoral epiphysis; osteoplasty of femoral neck (heyman type procedure)","date_of_service":"2026-05-10","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":"78135","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70390","name":"X-ray exam of salivary duct","description":"Sialography, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"C1879","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","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":"29075","name":"Appl cst elbw fngr short arm","description":"Application, cast; elbow to finger (short arm)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94250","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75980","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80412","name":"Crh stimulation panel","description":"Corticotropic releasing hormone (crh) stimulation panel this panel must include the following: cortisol (82533 x 6) adrenocorticotropic hormone (acth) (82024 x 6)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82943","name":"Assay of glucagon","description":"Glucagon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77072","name":"Bone age studies","description":"Bone age studies","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":698.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3214","name":"Benesch boot pair junior","description":"Benesch boot, pair, junior","date_of_service":"2026-05-10","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":"01922","name":"Anes n-invas img/radj ther","description":"Anesthesia for non-invasive imaging or radiation therapy","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29820","name":"Sho arthrs srg prtl synvct","description":"Arthroscopy, shoulder, surgical; synovectomy, partial","date_of_service":"2026-05-10","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":"74360","name":"X-ray guide gi dilation","description":"Intraluminal dilation of strictures and/or obstructions (eg, esophagus), radiological supervision and interpretation","date_of_service":"2026-05-10","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":"84300","name":"Assay of urine sodium","description":"Sodium; urine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"84133","name":"Assay of urine potassium","description":"Potassium; urine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"79440","name":"Nuclear rx intra-articular","description":"Radiopharmaceutical therapy, by intra-articular administration","date_of_service":"2026-05-10","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":"64630","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent; pudendal nerve","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1189.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"42400","name":"Biopsy of salivary gland","description":"Biopsy of salivary gland; needle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"L2810","name":"Knee control condylar pad","description":"Addition to lower extremity orthosis, knee control, condylar pad","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"89132","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01999","name":"Unlisted anes procedure","description":"Unlisted anesthesia procedure(s)","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2106","name":"Spherocylinder 4.00d/>6.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"L7261","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01260","name":"Anes all px veins upper leg","description":"Anesthesia for all procedures involving veins of upper leg, including exploration","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00566","name":"Anes direct cabg w/o pump","description":"Anesthesia for direct coronary artery bypass grafting; without pump oxygenator","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":604.76,"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":"42340","name":"Removal of salivary stone","description":"Sialolithotomy; parotid, extraoral or complicated intraoral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":958.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4004","name":"Cast sup shoulder cast fbrgl","description":"Cast supplies, shoulder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"88388","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"G0517","name":"Remove drug implant","description":"Removal of non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"01112","name":"Anes bone marrow aspir&/bx","description":"Anesthesia for bone marrow aspiration and/or biopsy, anterior or posterior iliac crest","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35241","name":"Rpr blvsl vn grf ntrthrc w/b","description":"Repair blood vessel with vein graft; intrathoracic, with bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1695.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"28446","name":"Opn osteochondrl agrft talus","description":"Open osteochondral autograft, talus (includes obtaining graft[s])","date_of_service":"2026-05-10","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":"56620","name":"Vulvectomy simple partial","description":"Vulvectomy simple; partial","date_of_service":"2026-05-10","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":"82820","name":"Hemoglobin-oxygen affinity","description":"Hemoglobin-oxygen affinity (po2 for 50% hemoglobin saturation with oxygen)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"91122","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90756","name":"Cciiv4 vacc abx free im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","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":32.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74260","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78605","name":"Brain image 4+ views","description":"Brain imaging, minimum 4 static views;","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"69740","name":"Repair facial nerve","description":"Suture facial nerve, intratemporal, with or without graft or decompression; lateral to geniculate ganglion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19272","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1973.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"32100","name":"Exploration of chest","description":"Thoracotomy; with exploration","date_of_service":"2026-05-10","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":"36870","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1630.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95910","name":"Nrv cndj test 7-8 studies","description":"Nerve conduction studies; 7-8 studies","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0740","name":"Non-implant pelv flr e-stim","description":"Non-implanted pelvic floor electrical stimulator, complete system","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"24344","name":"Reconstruct elbow lat ligmnt","description":"Reconstruction lateral collateral ligament, elbow, with tendon graft (includes harvesting of graft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"37766","name":"Phleb veins - extrem 20+","description":"Stab phlebectomy of varicose veins, 1 extremity; more than 20 incisions","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":660.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6204","name":"Composite drsg >16<=48 sq in","description":"Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"54115","name":"Treatment of penis lesion","description":"Removal foreign body from deep penile tissue (eg, plastic implant)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1760","name":"Closure dev, vasc","description":"Closure device, vascular (implantable/insertable)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99363","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54901","name":"Fusion of spermatic ducts","description":"Epididymovasostomy, anastomosis of epididymis to vas deferens; bilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":856.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":637.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"20824","name":"Replantation thumb complete","description":"Replantation, thumb (includes carpometacarpal joint to mp joint), complete amputation","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00140","name":"Anes procedures on eye nos","description":"Anesthesia for procedures on eye; not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"43020","name":"Incision of esophagus","description":"Esophagotomy, cervical approach, with removal of foreign body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0496","name":"Battery elec/combo vad, rep","description":"Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73521","name":"X-ray exam hips bi 2 views","description":"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"54390","name":"Repair penis and bladder","description":"Plastic operation on penis for epispadias distal to external sphincter; with exstrophy of bladder","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"95933","name":"Blink reflex test","description":"Orbicularis oculi (blink) reflex, by electrodiagnostic testing","date_of_service":"2026-05-10","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":"35820","name":"Explore chest vessels","description":"Exploration for postoperative hemorrhage, thrombosis or infection; chest","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":987.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":969.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"91111","name":"Gi trc img intral esophagus","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72100","name":"X-ray exam l-s spine 2/3 vws","description":"Radiologic examination, spine, lumbosacral; 2 or 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64640","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent; other peripheral nerve or branch","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0012","name":"Ltwt portbl power whlchr","description":"Lightweight portable motorized/power wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83586","name":"Assay 17- ketosteroids","description":"Ketosteroids, 17- (17-ks); total","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":766.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","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":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-10","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":"86625","name":"Campylobacter antibody","description":"Antibody; campylobacter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2179.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19125","name":"Excision breast lesion","description":"Excision of breast lesion identified by preoperative placement of radiological marker, open; single lesion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57555","name":"Remove cervix/repair vagina","description":"Excision of cervical stump, vaginal approach; with anterior and/or posterior repair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6535","name":"Gc stocking thighlngth 40+","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75562","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":714.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1027.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1123.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00868","name":"Anes xtrprtl px rnl transpl","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; renal transplant (recipient)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2038","name":"Kafo w/o joint multi-axis an","description":"Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated","date_of_service":"2026-05-10","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":"32652","name":"Thoracoscopy rem totl cortex","description":"Thoracoscopy, surgical; with total pulmonary decortication, including intrapleural pneumonolysis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1410.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00630","name":"Anes px lumbar region nos","description":"Anesthesia for procedures in lumbar region; not otherwise specified","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"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":"2026-05-10","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":"27400","name":"Revise thigh muscles/tendons","description":"Transfer, tendon or muscle, hamstrings to femur (eg, eggers type procedure)","date_of_service":"2026-05-10","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":"80197","name":"Assay of tacrolimus","description":"Tacrolimus","date_of_service":"2026-05-10","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":"78579","name":"Lung ventilation imaging","description":"Pulmonary ventilation imaging (eg, aerosol or gas)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92226","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1523.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"00851","name":"Anes iper px tubal ligation","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; tubal ligation/transection","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"55450","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70130","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; complete, minimum of 3 views per side","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36818","name":"Av fuse uppr arm cephalic","description":"Arteriovenous anastomosis, open; by upper arm cephalic vein transposition","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33420","name":"Revision of mitral valve","description":"Valvotomy, mitral valve; closed heart","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1492.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1298","name":"Wheelchair spec seat depth/w","description":"Special wheelchair seat depth and/or width, by construction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":903.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"21240","name":"Reconstruction of jaw joint","description":"Arthroplasty, temporomandibular joint, with or without autograft (includes obtaining graft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28304","name":"Incision of midfoot bones","description":"Osteotomy, tarsal bones, other than calcaneus or talus;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58285","name":"Extensive hysterectomy","description":"Vaginal hysterectomy, radical (schauta type operation)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1551.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"44310","name":"Ileostomy/jejunostomy","description":"Ileostomy or jejunostomy, non-tube","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L7272","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55540","name":"Revise hernia & sperm veins","description":"Excision of varicocele or ligation of spermatic veins for varicocele; with hernia repair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1350.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46707","name":"Repair anorectal fist w/plug","description":"Repair of anorectal fistula with plug (eg, porcine small intestine submucosa [sis])","date_of_service":"2026-05-10","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":"84143","name":"Assay of 17-hydroxypregneno","description":"17-hydroxypregnenolone","date_of_service":"2026-05-10","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":"95911","name":"Nrv cndj test 9-10 studies","description":"Nerve conduction studies; 9-10 studies","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":"27496","name":"Decompression of thigh/knee","description":"Decompression fasciotomy, thigh and/or knee, 1 compartment (flexor or extensor or adductor);","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40845","name":"Reconstruction of mouth","description":"Vestibuloplasty; complex (including ridge extension, muscle repositioning)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"59426","name":"Antepartum care only","description":"Antepartum care only; 7 or more visits","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8607","name":"Inj vocal cord bulking agent","description":"Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27437","name":"Revise kneecap","description":"Arthroplasty, patella; without prosthesis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0194","name":"Air fluidized bed","description":"Air fluidized bed","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77321","name":"Special teletx port plan","description":"Special teletherapy port plan, particles, hemibody, total body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"G0319","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5410","name":"Postop dsg bk ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"32402","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31786","name":"Remove windpipe lesion","description":"Excision of tracheal tumor or carcinoma; thoracic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1810.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2140.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92504","name":"Ear microscopy examination","description":"Binocular microscopy (separate diagnostic procedure)","date_of_service":"2026-05-10","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":"36470","name":"Njx sclrsnt 1 incmptnt vein","description":"Injection of sclerosant; single incompetent vein (other than telangiectasia)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95950","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77600","name":"Hyperthermia ext gen supfc","description":"Hyperthermia, externally generated; superficial (ie, heating to a depth of 4 cm or less)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"27557","name":"Treat knee dislocation","description":"Open treatment of knee dislocation, includes internal fixation, when performed; with primary ligamentous repair","date_of_service":"2026-05-10","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":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27600","name":"Decompression of lower leg","description":"Decompression fasciotomy, leg; anterior and/or lateral compartments only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"A4414","name":"Ost sknbar w/o conv<=4 sq in","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0290","name":"Hosp bed fx ht w/o rails w/m","description":"Hospital bed, fixed height, without side rails, with mattress","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2711.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"K0604","name":"Repl batt lithium 3.6 v","description":"Replacement battery for external infusion pump owned by patient, lithium, 3.6 volt, each","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"J7030","name":"Normal saline solution infus","description":"Infusion, normal saline solution , 1000 cc","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1358.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27487","name":"Revise/replace knee joint","description":"Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component","date_of_service":"2026-05-10","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":"24365","name":"Reconstruct head of radius","description":"Arthroplasty, radial head;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00914","name":"Anes trurl px rescj prst8","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of prostate","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"56632","name":"Vlvctmy rad prtl bi lymphad","description":"Vulvectomy, radical, partial; with bilateral inguinofemoral lymphadenectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1427.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00211","name":"Anes icr px crnec/crnot hmtm","description":"Anesthesia for intracranial procedures; craniotomy or craniectomy for evacuation of hematoma","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2260","name":"Reinforced solid stirrup","description":"Addition to lower extremity, reinforced solid stirrup (scott-craig type)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29085","name":"Appl cast hand&lwr forearm","description":"Application, cast; hand and lower forearm (gauntlet)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"26554","name":"Double transfer toe-hand","description":"Transfer, toe-to-hand with microvascular anastomosis; other than great toe, double","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4638.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95956","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"29888","name":"Arthrs aid acl rpr/agmntj","description":"Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73520","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77083","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"99364","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37790","name":"Penile venous occlusion","description":"Penile venous occlusive procedure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"92136","name":"Ophthalmic biometry","description":"Ophthalmic biometry by partial coherence interferometry with intraocular lens power calculation","date_of_service":"2026-05-10","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":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01860","name":"Anes forearm wrist/hand cast","description":"Anesthesia for forearm, wrist, or hand cast application, removal, or repair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"K0734","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24152","name":"Rad resection tum radial h/n","description":"Radical resection of tumor, radial head or neck","date_of_service":"2026-05-10","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":"71045","name":"X-ray exam chest 1 view","description":"Radiologic examination, chest; single view","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"27831","name":"Treat lower leg dislocation","description":"Closed treatment of proximal tibiofibular joint dislocation; requiring anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":446.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1348.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1520.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27250","name":"Treat hip dislocation","description":"Closed treatment of hip dislocation, traumatic; without anesthesia","date_of_service":"2026-05-10","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":"34490","name":"Removal of vein clot","description":"Thrombectomy, direct or with catheter; axillary and subclavian vein, by arm incision","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86617","name":"Lyme disease antibody","description":"Antibody; borrelia burgdorferi (lyme disease) confirmatory test (eg, western blot or immunoblot)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"54505","name":"Biopsy of testis","description":"Biopsy of testis, incisional (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["26"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44382","name":"Small bowel endoscopy","description":"Ileoscopy, through stoma; with biopsy, single or multiple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78465","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":428.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92556","name":"Speech audiometry complete","description":"Speech audiometry threshold; with speech recognition","date_of_service":"2026-05-10","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":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3220.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68700","name":"Repair tear ducts","description":"Plastic repair of canaliculi","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"67922","name":"Repair eyelid defect","description":"Repair of entropion; thermocauterization","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3969","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0978","name":"Axillary crutch extension","description":"Axillary crutch extension","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"75726","name":"Artery x-rays abdomen","description":"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation","date_of_service":"2026-05-10","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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8515","name":"Gel cap app device for trach","description":"Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78630","name":"Cerebrospinal fluid scan","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"A5073","name":"Urinary pouch on barr w/flng","description":"Ostomy pouch, urinary; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59151","name":"Treat ectopic pregnancy","description":"Laparoscopic treatment of ectopic pregnancy; with salpingectomy and/or oophorectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57510","name":"Cauterization of cervix","description":"Cautery of cervix; electro or thermal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"44160","name":"Removal of colon","description":"Colectomy, partial, with removal of terminal ileum with ileocolostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1275.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0101","name":"Ca screen;pelvic/breast exam","description":"Cervical or vaginal cancer screening; pelvic and clinical breast examination","date_of_service":"2026-05-10","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":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","date_of_service":"2026-05-10","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":"E1190","name":"Wheelchair amputee w/ leg re","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable elevating legrests","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01960","name":"Anes vaginal delivery only","description":"Anesthesia for vaginal delivery only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J2510","name":"Penicillin g procaine inj","description":"Injection, penicillin g procaine, aqueous, up to 600,000 units","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67311","name":"Revise eye muscle","description":"Strabismus surgery, recession or resection procedure; 1 horizontal muscle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2050.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1845","name":"Ko double upright pre cst","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70300","name":"X-ray exam of teeth","description":"Radiologic examination, teeth; single view","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33468","name":"Revision of tricuspid valve","description":"Tricuspid valve repositioning and plication for ebstein anomaly","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2136.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70548","name":"Mr angiography neck w/dye","description":"Magnetic resonance angiography, neck; with contrast material(s)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67914","name":"Repair eyelid defect","description":"Repair of ectropion; suture","date_of_service":"2026-05-10","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":"29046","name":"Appl bdy cst sho to hip b th","description":"Application of body cast, shoulder to hips; including both thighs","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1844","name":"Ko w/adj jt rot cntrl molded","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":761.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67115","name":"Release encircling material","description":"Release of encircling material (posterior segment)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82945","name":"Glucose other fluid","description":"Glucose, body fluid, other than blood","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-10","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":"00770","name":"Anes px maj abd blood vessel","description":"Anesthesia for all procedures on major abdominal blood vessels","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":364.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23200","name":"Radical rescj tumor clavicle","description":"Radical resection of tumor; clavicle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1280.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27030","name":"Arthrotomy hip w/drainage","description":"Arthrotomy, hip, with drainage (eg, infection)","date_of_service":"2026-05-10","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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77083","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1445.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"82760","name":"Assay of galactose","description":"Galactose","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2293.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"27098","name":"Transfer tendon to pelvis","description":"Transfer, adductor to ischium","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"01210","name":"Anes open px hip joint nos","description":"Anesthesia for open procedures involving hip joint; not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","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":"27269","name":"Optx thigh fx","description":"Open treatment of femoral fracture, proximal end, head, includes internal fixation, when performed","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":480.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2212","name":"Lens sphcyl bifo 7.25-12/2.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"92543","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-10","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":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"84437","name":"Assay of neonatal thyroxine","description":"Thyroxine; requiring elution (eg, neonatal)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92543","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-10","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":"00148","name":"Anes px eye ophthalmoscopy","description":"Anesthesia for procedures on eye; ophthalmoscopy","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1367.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42340","name":"Removal of salivary stone","description":"Sialolithotomy; parotid, extraoral or complicated intraoral","date_of_service":"2026-05-10","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":"82009","name":"Ketone bodys qual","description":"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); qualitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0734","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"27185","name":"Revision of femur epiphysis","description":"Epiphyseal arrest by epiphysiodesis or stapling, greater trochanter of femur","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61548","name":"Removal of pituitary gland","description":"Hypophysectomy or excision of pituitary tumor, transnasal or transseptal approach, nonstereotactic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75572","name":"Ct hrt w/3d image","description":"Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology (including 3d image postprocessing, assessment of cardiac function, and evaluation of venous structures, if performed)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G6013","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33861","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","date_of_service":"2026-05-10","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":"53060","name":"Drainage of urethra abscess","description":"Drainage of skenes gland abscess or cyst","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-10","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":"G2063","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1708.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1150.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3930","name":"Hfo nontorsion jnts pre ots","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1573.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"61500","name":"Crnec exc tum/bone les skull","description":"Craniectomy; with excision of tumor or other bone lesion of skull","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83088","name":"Assay of histamine","description":"Histamine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-05-10","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":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1665.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"J0636","name":"Inj calcitriol per 0.1 mcg","description":"Injection, calcitriol, 0.1 mcg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3962","name":"Sewho erbs palsey design abd","description":"Shoulder elbow wrist hand orthosis, abduction positioning, erbs palsey design, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"49421","name":"Ins tun ip cath for dial opn","description":"Insertion of tunneled intraperitoneal catheter for dialysis, open","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92568","name":"Acoustic refl threshold tst","description":"Acoustic reflex testing, threshold","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25150","name":"Partial removal of ulna","description":"Partial excision (craterization, saucerization, or diaphysectomy) of bone (eg, for osteomyelitis); ulna","date_of_service":"2026-05-10","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":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"89125","name":"Specimen fat stain","description":"Fat stain, feces, urine, or respiratory secretions","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-10","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":"23331","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":705.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2250","name":"Inj midazolam hydrochloride","description":"Injection, midazolam hydrochloride, per 1 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69950","name":"Incise inner ear nerve","description":"Vestibular nerve section, transcranial approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78013","name":"Thyroid imaging w/blood flow","description":"Thyroid imaging (including vascular flow, when performed);","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22590","name":"Arthrd pst tq craniocervical","description":"Arthrodesis, posterior technique, craniocervical (occiput-c2)","date_of_service":"2026-05-10","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":"41821","name":"Excision of gum flap","description":"Operculectomy, excision pericoronal tissues","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1076.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1934.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2703.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2302","name":"Lens sphere trifocal 7.12-20","description":"Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00, per lens","date_of_service":"2026-05-10","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":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50940","name":"Release of ureter","description":"Deligation of ureter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2385","name":"Straight knee joint heavy du","description":"Addition to lower extremity, straight knee joint, heavy duty, each joint","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6696","name":"Cus elbo skt in for con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"88386","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68040","name":"Treatment of eyelid lesions","description":"Expression of conjunctival follicles (eg, for trachoma)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":995.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1055.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"50660","name":"Removal of ureter","description":"Ureterectomy, total, ectopic ureter, combination abdominal, vaginal and/or perineal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7034","name":"Nasal application device","description":"Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap","date_of_service":"2026-05-10","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":"58565","name":"Hysteroscopy sterilization","description":"Hysteroscopy, surgical; with bilateral fallopian tube cannulation to induce occlusion by placement of permanent implants","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":549.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"28430","name":"Cltx talus fracture w/o mnpj","description":"Closed treatment of talus fracture; without manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"92555","name":"Speech threshold audiometry","description":"Speech audiometry threshold;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64776","name":"Remove digit nerve lesion","description":"Excision of neuroma; digital nerve, 1 or both, same digit","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"72090","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J0800","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3037.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4235","name":"Lithium batt for glucose mon","description":"Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42300","name":"Drainage of salivary gland","description":"Drainage of abscess; parotid, simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"27390","name":"Incision of thigh tendon","description":"Tenotomy, open, hamstring, knee to hip; single tendon","date_of_service":"2026-05-10","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":"E0610","name":"Pacemaker monitr audible/vis","description":"Pacemaker monitor, self-contained, (checks battery depletion, includes audible and visible check systems)","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"27424","name":"Revision/removal of kneecap","description":"Reconstruction of dislocating patella; with patellectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88365","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; initial single probe stain procedure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"52276","name":"Cystoscopy and treatment","description":"Cystourethroscopy with direct vision internal urethrotomy","date_of_service":"2026-05-10","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":"E1238","name":"Fld ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, folding, adjustable, without seating system","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78812","name":"Pet image skull-thigh","description":"Positron emission tomography (pet) imaging; skull base to mid-thigh","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86738","name":"Mycoplasma antibody","description":"Antibody; mycoplasma","date_of_service":"2026-05-10","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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1829.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"44901","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97014","name":"Electric stimulation therapy","description":"Application of a modality to 1 or more areas; electrical stimulation (unattended)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27842","name":"Treat ankle dislocation","description":"Closed treatment of ankle dislocation; requiring anesthesia, with or without percutaneous skeletal fixation","date_of_service":"2026-05-10","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":"00790","name":"Anes iper upr abd nos","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; not otherwise specified","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":"24560","name":"Cltx hum epcndylr fx wo mnpj","description":"Closed treatment of humeral epicondylar fracture, medial or lateral; without manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35695","name":"Art trnsposj carotid subclav","description":"Transposition and/or reimplantation; carotid to subclavian artery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1362.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15331","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29200","name":"Strapping thorax","description":"Strapping; thorax","date_of_service":"2026-05-10","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":"28202","name":"Repair/graft of foot tendon","description":"Repair, tendon, flexor, foot; secondary with free graft, each tendon (includes obtaining graft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2205.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"77401","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88240","name":"Cell cryopreserve/storage","description":"Cryopreservation, freezing and storage of cells, each cell line","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"31513","name":"Injection into vocal cord","description":"Laryngoscopy, indirect; with vocal cord injection","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4615","name":"Cannula nasal","description":"Cannula, nasal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"26605","name":"Treat metacarpal fracture","description":"Closed treatment of metacarpal fracture, single; with manipulation, each bone","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76645","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"77285","name":"Ther rad simulaj field intrm","description":"Therapeutic radiology simulation-aided field setting; intermediate","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47721","name":"Fuse upper gi structures","description":"Cholecystoenterostomy; with gastroenterostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01472","name":"Anes rpr rpt achilles tendon","description":"Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot; repair of ruptured achilles tendon, with or without graft","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69955","name":"Release facial nerve","description":"Total facial nerve decompression and/or repair (may include graft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1596.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44188","name":"Lap colostomy","description":"Laparoscopy, surgical, colostomy or skin level cecostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1283.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"51570","name":"Removal of bladder","description":"Cystectomy, complete; (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1563.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1126.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50544","name":"Laparoscopy pyeloplasty","description":"Laparoscopy, surgical; pyeloplasty","date_of_service":"2026-05-10","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":"45190","name":"Destruction rectal tumor","description":"Destruction of rectal tumor (eg, electrodesiccation, electrosurgery, laser ablation, laser resection, cryosurgery) transanal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"42335","name":"Removal of salivary stone","description":"Sialolithotomy; submandibular (submaxillary), complicated, intraoral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":831.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","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":"87166","name":"Dark field exam w/o collj","description":"Dark field examination, any source (eg, penile, vaginal, oral, skin); without collection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"40806","name":"Incision of lip fold","description":"Incision of labial frenum (frenotomy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"G0430","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"60100","name":"Biopsy of thyroid","description":"Biopsy thyroid, percutaneous core needle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"61440","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2211.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"78020","name":"Thyroid met uptake","description":"Thyroid carcinoma metastases uptake (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33412","name":"Replacement of aortic valve","description":"Replacement, aortic valve; with transventricular aortic annulus enlargement (konno procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3089.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50236","name":"Removal of kidney & ureter","description":"Nephrectomy with total ureterectomy and bladder cuff; through separate incision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30580","name":"Repair upper jaw fistula","description":"Repair fistula; oromaxillary (combine with 31030 if antrotomy is included)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01160","name":"Anes clsd px symph pub/si jt","description":"Anesthesia for closed procedures involving symphysis pubis or sacroiliac joint","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86155","name":"Chemotaxis assay","description":"Chemotaxis assay, specify method","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"35331","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; abdominal aorta","date_of_service":"2026-05-10","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":"66825","name":"Reposition intraocular lens","description":"Repositioning of intraocular lens prosthesis, requiring an incision (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43130","name":"Removal of esophagus pouch","description":"Diverticulectomy of hypopharynx or esophagus, with or without myotomy; cervical approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"19260","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":763.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31615","name":"Trcheobrnchsc est trachs inc","description":"Tracheobronchoscopy through established tracheostomy incision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63182","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4047","name":"Cast sup sht leg splnt ped p","description":"Cast supplies, short leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"51725","name":"Simple cystometrogram","description":"Simple cystometrogram (cmg) (eg, spinal manometer)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"63270","name":"Excise intrspinl lesion crvl","description":"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; cervical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2260.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"31590","name":"Reinnervate larynx","description":"Laryngeal reinnervation by neuromuscular pedicle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32815","name":"Close bronchial fistula","description":"Open closure of major bronchial fistula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1673.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"76642","name":"Ultrasound breast limited","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited","date_of_service":"2026-05-10","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":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1473.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"ATP12","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"27252","name":"Treat hip dislocation","description":"Closed treatment of hip dislocation, traumatic; requiring anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":881.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"26230","name":"Partial removal of hand bone","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis); metacarpal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":604.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"27403","name":"Repair of knee cartilage","description":"Arthrotomy with meniscus repair, knee","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21720","name":"Revision of neck muscle","description":"Division of sternocleidomastoid for torticollis, open operation; without cast application","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":464.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83986","name":"Assay ph body fluid nos","description":"Ph; body fluid, not otherwise specified","date_of_service":"2026-05-10","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":"35654","name":"Bpg axillary-femoral-femoral","description":"Bypass graft, with other than vein; axillary-femoral-femoral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1749.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86886","name":"Coombs test indirect titer","description":"Antihuman globulin test (coombs test); indirect, each antibody titer","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"29900","name":"Mcp joint arthroscopy dx","description":"Arthroscopy, metacarpophalangeal joint, diagnostic, includes synovial biopsy","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["26"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2589.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":891.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"72125","name":"Ct neck spine w/o dye","description":"Computed tomography, cervical spine; without contrast material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8603","name":"Collagen imp urinary 2.5 ml","description":"Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83901","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19340","name":"Insj breast implt sm d mast","description":"Insertion of breast implant on same day of mastectomy (ie, immediate)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"42802","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"46083","name":"Inc thrombosed hroid xtrnl","description":"Incision of thrombosed hemorrhoid, external","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73660","name":"X-ray exam of toe(s)","description":"Radiologic examination; toe(s), minimum of 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65435","name":"Curette/treat cornea","description":"Removal of corneal epithelium; with or without chemocauterization (abrasion, curettage)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39560","name":"Resect diaphragm simple","description":"Resection, diaphragm; with simple repair (eg, primary suture)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"74450","name":"X-ray urethra/bladder","description":"Urethrocystography, retrograde, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1730","name":"Diazoxide injection","description":"Injection, diazoxide, up to 300 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"50500","name":"Repair of kidney wound","description":"Nephrorrhaphy, suture of kidney wound or injury","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1055.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50320","name":"Remove kidney living donor","description":"Donor nephrectomy (including cold preservation); open, from living donor","date_of_service":"2026-05-10","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":"93533","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1742.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24582","name":"Prq skel fix humrl cndylr fx","description":"Percutaneous skeletal fixation of humeral condylar fracture, medial or lateral, with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90688","name":"Iiv4 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","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":20.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"14000","name":"Tis trnfr trunk 10 sq cm/<","description":"Adjacent tissue transfer or rearrangement, trunk; defect 10 sq cm or less","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90785","name":"Psytx complex interactive","description":"Interactive complexity (list separately in addition to the code for primary procedure)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82679","name":"Assay of estrone","description":"Estrone","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"23465","name":"Repair shoulder capsule","description":"Capsulorrhaphy, glenohumeral joint, posterior, with or without bone block","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":947.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74020","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP22","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"44640","name":"Repair bowel-skin fistula","description":"Closure of intestinal cutaneous fistula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"L3672","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0200","name":"Heat lamp without stand","description":"Heat lamp, without stand (table model), includes bulb, or infrared element","date_of_service":"2026-05-10","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":"25375","name":"Revise radius & ulna","description":"Multiple osteotomies, with realignment on intramedullary rod (sofield type procedure); radius and ulna","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"E1223","name":"Wheelchair spec size w foot","description":"Wheelchair with detachable arms, footrests","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"00352","name":"Anes px maj vsl nck smpl lig","description":"Anesthesia for procedures on major vessels of neck; simple ligation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"L6036","name":"Prosthetic thumb mechanical","description":"Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1023.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"J7188","name":"Factor viii recomb obizur","description":"Injection, factor viii (antihemophilic factor, recombinant), (obizur), per i.u.","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"78272","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84206","name":"Assay of proinsulin","description":"Proinsulin","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91319","name":"Sarscv2 vac 10mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 10 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","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":77.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3360","name":"Diazepam injection","description":"Injection, diazepam, up to 5 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.16,"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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1212.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29867","name":"Allgrft implnt knee w/scope","description":"Arthroscopy, knee, surgical; osteochondral allograft (eg, mosaicplasty)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97004","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64766","name":"Incise hip/thigh nerve","description":"Transection or avulsion of obturator nerve, intrapelvic, with or without adductor tenotomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53240","name":"Surgery for urethra pouch","description":"Marsupialization of urethral diverticulum, male or female","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"94200","name":"Lung function test (mbc/mvv)","description":"Maximum breathing capacity, maximal voluntary ventilation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":"0269T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6590","name":"Urinary cath disp suc pump","description":"External urinary catheters; disposable, with wicking material, for use with suction pump, per month","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"68525","name":"Biopsy of tear sac","description":"Biopsy of lacrimal sac","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25230","name":"Partial removal of radius","description":"Radial styloidectomy (separate procedure)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1512.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1371.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78258","name":"Esophageal motility","description":"Esophageal motility","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"43456","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"90821","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"94620","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67550","name":"Insert eye socket implant","description":"Orbital implant (implant outside muscle cone); insertion","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"27093","name":"Injection for hip x-ray","description":"Injection procedure for hip arthrography; without anesthesia","date_of_service":"2026-05-10","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":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"36822","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":477.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":856.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95913","name":"Nrv cndj test 13/> studies","description":"Nerve conduction studies; 13 or more studies","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46750","name":"Repair of anal sphincter","description":"Sphincteroplasty, anal, for incontinence or prolapse; adult","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1128.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"52301","name":"Cystoscopy and treatment","description":"Cystourethroscopy; with resection or fulguration of ectopic ureterocele(s), unilateral or bilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73565","name":"X-ray exam of knees","description":"Radiologic examination, knee; both knees, standing, anteroposterior","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93278","name":"Ecg/signal-averaged","description":"Signal-averaged electrocardiography (saecg), with or without ecg","date_of_service":"2026-05-10","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":"83916","name":"Oligoclonal bands","description":"Oligoclonal immune (oligoclonal bands)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35533","name":"Art byp grft axill/fem/fem","description":"Bypass graft, with vein; axillary-femoral-femoral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1935.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"27450","name":"Incision of thigh","description":"Osteotomy, femur, shaft or supracondylar; with fixation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71045","name":"X-ray exam chest 1 view","description":"Radiologic examination, chest; single view","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1235","name":"Rigid ped wc adjustable","description":"Wheelchair, pediatric size, rigid, adjustable, with seating system","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"24357","name":"Repair elbow perc","description":"Tenotomy, elbow, lateral or medial (eg, epicondylitis, tennis elbow, golfers elbow); percutaneous","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44389","name":"Colonoscopy with biopsy","description":"Colonoscopy through stoma; with biopsy, single or multiple","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1120.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0330","name":"Succinycholine chloride inj","description":"Injection, succinylcholine chloride, up to 20 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27732","name":"Repair of fibula epiphysis","description":"Arrest, epiphyseal (epiphysiodesis), open; distal fibula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"71046","name":"X-ray exam chest 2 views","description":"Radiologic examination, chest; 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64472","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":842.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"00906","name":"Anes vulvectomy","description":"Anesthesia for; vulvectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9483","name":"Remote e/m new pt 30mins","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved cms innovation center demonstration project, which requires these 3 key components: a detailed history; a detailed examination; medical decision making of low complexity, furnished in real tim","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"88189","name":"Flowcytometry/read 16 & >","description":"Flow cytometry, interpretation; 16 or more markers","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70140","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; less than 3 views","date_of_service":"2026-05-10","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":"L6883","name":"Replc sockt below e/w disa","description":"Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01120","name":"Anes px on bony pelvis","description":"Anesthesia for procedures on bony pelvis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"17306","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00190","name":"Anes px facial b1/skull nos","description":"Anesthesia for procedures on facial bones or skull; not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"95920","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"29843","name":"Wrist arthroscopy/surgery","description":"Arthroscopy, wrist, surgical; for infection, lavage and drainage","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0499","name":"Belt/vest elec/combo vad rep","description":"Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38381","name":"Thoracic duct procedure","description":"Suture and/or ligation of thoracic duct; thoracic approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L0470","name":"Tlso rigid frame pre subclav","description":"Tlso, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction to scapula, lateral strength provided by pelvic, thoracic, and lateral frame pieces, rotational strength provided by subclavicular extensions, restr","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2215","name":"Lens lenticular bifocal","description":"Lenticular (myodisc), per lens, bifocal","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29260","name":"Strapping of elbow or wrist","description":"Strapping; elbow or wrist","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75724","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88187","name":"Flowcytometry/read 2-8","description":"Flow cytometry, interpretation; 2 to 8 markers","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0783","name":"Programmable infusion pump","description":"Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26250","name":"Extensive hand surgery","description":"Radical resection of tumor, metacarpal","date_of_service":"2026-05-10","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":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86301","name":"Immunoassay tumor ca 19-9","description":"Immunoassay for tumor antigen, quantitative; ca 19-9","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L8642","name":"Hallux implant","description":"Hallux implant","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75958","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53400","name":"Revise urethra stage 1","description":"Urethroplasty; first stage, for fistula, diverticulum, or stricture (eg, johannsen type)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":868.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"72128","name":"Ct chest spine w/o dye","description":"Computed tomography, thoracic spine; without contrast material","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48146","name":"Pancreatectomy","description":"Pancreatectomy, distal, near-total with preservation of duodenum (child-type procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1866.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72010","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4369","name":"Skin barrier liquid per oz","description":"Ostomy skin barrier, liquid (spray, brush, etc.), per oz","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"15820","name":"Blepharoplasty lower eyelid","description":"Blepharoplasty, lower eyelid;","date_of_service":"2026-05-10","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":"78428","name":"Cardiac shunt imaging","description":"Cardiac shunt detection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66185","name":"Revise aqueous shunt eye","description":"Revision of aqueous shunt to extraocular equatorial plate reservoir; with graft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"G0462","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38115","name":"Repair of ruptured spleen","description":"Repair of ruptured spleen (splenorrhaphy) with or without partial splenectomy","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"50526","name":"Close nephrovisceral fistula","description":"Closure of nephrovisceral fistula (eg, renocolic), including visceral repair; thoracic approach","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88344","name":"Imhchem/imcytchm ea mlt antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82145","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"42310","name":"Drainage of salivary gland","description":"Drainage of abscess; submaxillary or sublingual, intraoral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00906","name":"Anes vulvectomy","description":"Anesthesia for; vulvectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"99271","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KF"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"35563","name":"Art byp grft ilioiliac","description":"Bypass graft, with vein; ilioiliac","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"68200","name":"Treat eyelid by injection","description":"Subconjunctival injection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53505","name":"Repair of urethra injury","description":"Urethrorrhaphy, suture of urethral wound or injury; penile","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"S9152","name":"Speech therapy, re-eval","description":"Speech therapy, re-evaluation","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"48548","name":"Fuse pancreas and bowel","description":"Pancreaticojejunostomy, side-to-side anastomosis (puestow-type operation)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44320","name":"Colostomy","description":"Colostomy or skin level cecostomy;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"G0511","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77777","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6203","name":"Composite drsg <= 16 sq in","description":"Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30400","name":"Reconstruction of nose","description":"Rhinoplasty, primary; lateral and alar cartilages and/or elevation of nasal tip","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94657","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1587.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E1830","name":"Adjust toe ext & flex device","description":"Dynamic adjustable toe extension and flexion device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53510","name":"Repair of urethra injury","description":"Urethrorrhaphy, suture of urethral wound or injury; perineal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43882","name":"Rev/rmvl gstr nstim eltrd","description":"Revision or removal of gastric neurostimulator electrodes, antrum, open","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5150","name":"Mold sckt ext knee shin sach","description":"Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0620","name":"Cap bld skin piercing laser","description":"Skin piercing device for collection of capillary blood, laser, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1667.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5585","name":"Prep ak ischial open end","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45820","name":"Repair rectourethral fistula","description":"Closure of rectourethral fistula;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1214.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4012","name":"Cast sup sht arm ped fbrglas","description":"Cast supplies, short arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0870","name":"Tract frame attach footboard","description":"Traction frame, attached to footboard, extremity traction, (e.g., bucks)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A6549","name":"Grad com garm noc day use","description":"Gradient compression garment, not otherwise specified, for daytime use, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80100","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17310","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75803","name":"Lymph vessel x-ray arms/legs","description":"Lymphangiography, extremity only, bilateral, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"34471","name":"Removal of vein clot","description":"Thrombectomy, direct or with catheter; subclavian vein, by neck incision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31291","name":"Nasal/sinus endoscopy surg","description":"Nasal/sinus endoscopy, surgical, with repair of cerebrospinal fluid leak; sphenoid region","date_of_service":"2026-05-10","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":"A4409","name":"Ost skn barr convex <=4 sq i","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-10","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":"K0737","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"88130","name":"Sex chromatin identification","description":"Sex chromatin identification; barr bodies","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2081.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70486","name":"Ct maxillofacial w/o dye","description":"Computed tomography, maxillofacial area; without contrast material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"48153","name":"Pancreatectomy","description":"Pancreatectomy, proximal subtotal with near-total duodenectomy, choledochoenterostomy and duodenojejunostomy (pylorus-sparing, whipple-type procedure); with pancreatojejunostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","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":"2026-05-10","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":"64790","name":"Removal of nerve lesion","description":"Excision of neurofibroma or neurolemmoma; major peripheral nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":933.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"44660","name":"Repair bowel-bladder fistula","description":"Closure of enterovesical fistula; without intestinal or bladder resection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46070","name":"Incision anal septum infant","description":"Incision, anal septum (infant)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"72100","name":"X-ray exam l-s spine 2/3 vws","description":"Radiologic examination, spine, lumbosacral; 2 or 3 views","date_of_service":"2026-05-10","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":"88264","name":"Chromosome analysis 20-25","description":"Chromosome analysis; analyze 20-25 cells","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82383","name":"Assay blood catecholamines","description":"Catecholamines; blood","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99334","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"87081","name":"Culture screen only","description":"Culture, presumptive, pathogenic organisms, screening only;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1850","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","date_of_service":"2026-05-10","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":"95979","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1469.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":837.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32225","name":"Partial release of lung","description":"Decortication, pulmonary (separate procedure); partial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95822","name":"Eeg coma or sleep only","description":"Electroencephalogram (eeg); recording in coma or sleep only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74327","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78012","name":"Thyroid uptake measurement","description":"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74420","name":"Urography rtrgr +-kub","description":"Urography, retrograde, with or without kub","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0643","name":"Lso sag ctr rigi pos pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1194.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","date_of_service":"2026-05-10","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":"E0620","name":"Cap bld skin piercing laser","description":"Skin piercing device for collection of capillary blood, laser, each","date_of_service":"2026-05-10","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":"K0734","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KF"]}],"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":"2026-05-10","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":"43279","name":"Lap myotomy heller","description":"Laparoscopy, surgical, esophagomyotomy (heller type), with fundoplasty, when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1076.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0504","name":"Pwr adpt pneum vad, rep veh","description":"Power adapter for pneumatic ventricular assist device, replacement only, vehicle type","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4619","name":"Face tent","description":"Face tent","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":779.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93508","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":931.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0622","name":"Sio flex pelvisacral custom","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","date_of_service":"2026-05-10","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":"25565","name":"Cltx rdl&uln shft fx w/mnpj","description":"Closed treatment of radial and ulnar shaft fractures; with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"L5811","name":"Endo knee-shin mnl lck ultra","description":"Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83630","name":"Lactoferrin fecal (qual)","description":"Lactoferrin, fecal; qualitative","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75822","name":"Vein x-ray arms/legs","description":"Venography, extremity, bilateral, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"91040","name":"Esoph balloon distension tst","description":"Esophageal balloon distension study, diagnostic, with provocation when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"78205","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"83499","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9190","name":"Fluorouracil injection","description":"Injection, fluorouracil, 500 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"86822","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86771","name":"Shigella antibody","description":"Antibody; shigella","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"82248","name":"Bilirubin direct","description":"Bilirubin; direct","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2031.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21077","name":"Impres&prep orbital prosth","description":"Impression and custom preparation; orbital prosthesis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2906.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1707.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"1126F","name":"Amnt pain noted none prsnt","description":"Pain severity quantified; no pain present (coa) (onc)","date_of_service":"2026-05-10","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":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"62223","name":"Establish brain cavity shunt","description":"Creation of shunt; ventriculo-peritoneal, -pleural, other terminus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":935.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92542","name":"Positional nystagmus test","description":"Positional nystagmus test, minimum of 4 positions, with recording","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"P9043","name":"Plasma protein fract,5%,50ml","description":"Infusion, plasma protein fraction (human), 5%, 50 ml","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22524","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64752","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"47362","name":"Repair liver wound","description":"Management of liver hemorrhage; re-exploration of hepatic wound for removal of packing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0762","name":"Trans elec jt stim dev sys","description":"Transcutaneous electrical joint stimulation device system, includes all accessories","date_of_service":"2026-05-10","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":"27880","name":"Amputation of lower leg","description":"Amputation, leg, through tibia and fibula;","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"75801","name":"Lymph vessel x-ray arm/leg","description":"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3961","name":"Sewho cap design w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7259","name":"Electronic wrist rotator any","description":"Electronic wrist rotator, any type","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"21085","name":"Impres&prep oral surg splint","description":"Impression and custom preparation; oral surgical splint","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"31370","name":"Partial removal of larynx","description":"Partial laryngectomy (hemilaryngectomy); horizontal","date_of_service":"2026-05-10","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":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"25130","name":"Removal of wrist lesion","description":"Excision or curettage of bone cyst or benign tumor of carpal bones;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49611","name":"Repair umbilical lesion","description":"Repair of omphalocele (gross type operation); second stage","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":745.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"21267","name":"Revise eye sockets","description":"Orbital repositioning, periorbital osteotomies, unilateral, with bone grafts; extracranial approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"84431","name":"Thromboxane urine","description":"Thromboxane metabolite(s), including thromboxane if performed, urine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86587","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33468","name":"Revision of tricuspid valve","description":"Tricuspid valve repositioning and plication for ebstein anomaly","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2135.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92512","name":"Nasal function studies","description":"Nasal function studies (eg, rhinomanometry)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00908","name":"Anes perineal prostatectomy","description":"Anesthesia for; perineal prostatectomy","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37766","name":"Phleb veins - extrem 20+","description":"Stab phlebectomy of varicose veins, 1 extremity; more than 20 incisions","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66020","name":"Injection treatment of eye","description":"Injection, anterior chamber of eye (separate procedure); air or liquid","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44680","name":"Surgical revision intestine","description":"Intestinal plication (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1054.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"95861","name":"Needle emg 2 extremities","description":"Needle electromyography; 2 extremities with or without related paraspinal areas","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64565","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4354","name":"Cath insertion tray w/bag","description":"Insertion tray with drainage bag but without catheter","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51010","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":518.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"33366","name":"Trcath replace aortic valve","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; transapical exposure (eg, left thoracotomy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2110.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67900","name":"Repair brow defect","description":"Repair of brow ptosis (supraciliary, mid-forehead or coronal approach)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95075","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"44144","name":"Partial removal of colon","description":"Colectomy, partial; with resection, with colostomy or ileostomy and creation of mucofistula","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5280","name":"Hemipelvect canad sing axis","description":"Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82487","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"53520","name":"Repair of urethra defect","description":"Closure of urethrostomy or urethrocutaneous fistula, male (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15570","name":"Skin pedicle flap trunk","description":"Formation of direct or tubed pedicle, with or without transfer; trunk","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1038","name":"Transport chair pt wt<=300lb","description":"Transport chair, adult size, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1472.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27284","name":"Arthrodesis hip joint","description":"Arthrodesis, hip joint (including obtaining graft);","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1368.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78206","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"45345","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"59830","name":"Treat uterus infection","description":"Treatment of septic abortion, completed surgically","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1136.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2661.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KM"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L5712","name":"Knee-shin exo frict swg & st","description":"Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4673","name":"Ext line w easy lock connect","description":"Extension line with easy lock connectors, used with dialysis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1523.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95912","name":"Nrv cndj test 11-12 studies","description":"Nerve conduction studies; 11-12 studies","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":"64614","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57061","name":"Destruction vag lesions smpl","description":"Destruction of vaginal lesion(s); simple (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11976","name":"Remove contraceptive capsule","description":"Removal, implantable contraceptive capsules","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"32673","name":"Thoracoscopy w/thymus resect","description":"Thoracoscopy, surgical; with resection of thymus, unilateral or bilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27370","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74420","name":"Urography rtrgr +-kub","description":"Urography, retrograde, with or without kub","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3765","name":"Ewhfo rigid w/o jnts cf","description":"Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":674.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7400","name":"Add ue prost be/wd, ultlite","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","date_of_service":"2026-05-10","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":"G0202","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95864","name":"Needle emg 4 extremities","description":"Needle electromyography; 4 extremities with or without related paraspinal areas","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0485T","name":"Oct mid ear i&r unilateral","description":"Optical coherence tomography (oct) of middle ear, with interpretation and report; unilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":488.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"70355","name":"Panoramic x-ray of jaws","description":"Orthopantogram (eg, panoramic x-ray)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"51741","name":"Electro-uroflowmetry first","description":"Complex uroflowmetry (eg, calibrated electronic equipment)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-05-10","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":"23472","name":"Reconstruct shoulder joint","description":"Arthroplasty, glenohumeral joint; total shoulder (glenoid and proximal humeral replacement (eg, total shoulder))","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"75558","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-05-10","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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1825","name":"Adjust finger ext & flex dev","description":"Dynamic adjustable finger extension and flexion device, includes soft interface material","date_of_service":"2026-05-10","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":"L2520","name":"Th/wght bear quad-lat brim c","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, custom fitted","date_of_service":"2026-05-10","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":"49060","name":"Drain open retroperi abscess","description":"Drainage of retroperitoneal abscess, open","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1110.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"32663","name":"Thoracoscopy w/lobectomy","description":"Thoracoscopy, surgical; with lobectomy (single lobe)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1436.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"L3930","name":"Hfo nontorsion jnts pre ots","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"37229","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":374.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84085","name":"Assay of rbc pg6d enzyme","description":"Phosphogluconate, 6-, dehydrogenase, rbc","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1028.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99293","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":943.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"91133","name":"Electrogastrography w/test","description":"Electrogastrography, diagnostic, transcutaneous; with provocative testing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G6002","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93562","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"L3207","name":"Hightop w/ supp/pronator jun","description":"Orthopedic shoe, hightop with supinator or pronator, junior","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41153","name":"Tongue mouth neck surgery","description":"Glossectomy; composite procedure with resection floor of mouth, with suprahyoid neck dissection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1856.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"44345","name":"Revision of colostomy","description":"Revision of colostomy; complicated (reconstruction in-depth) (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"99144","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58350","name":"Reopen fallopian tube","description":"Chromotubation of oviduct, including materials","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5726","name":"Knee-shin ext jnts fld swg e","description":"Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":756.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"53430","name":"Reconstruction of urethra","description":"Urethroplasty, reconstruction of female urethra","date_of_service":"2026-05-10","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":"43401","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78282","name":"Gi protein loss","description":"Gastrointestinal protein loss","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57120","name":"Colpocleisis le fort type","description":"Colpocleisis (le fort type)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85230","name":"Clot factor vii proconvertin","description":"Clotting; factor vii (proconvertin, stable factor)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67915","name":"Repair eyelid defect","description":"Repair of ectropion; thermocauterization","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90809","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":842.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-05-10","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":"L6955","name":"Above elbow myoelectronic ct","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":415.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53410","name":"Reconstruction of urethra","description":"Urethroplasty, 1-stage reconstruction of male anterior urethra","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1078.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0019T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"29055","name":"Appl cast shoulder spica","description":"Application, cast; shoulder spica","date_of_service":"2026-05-10","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":"25031","name":"I&d forearm&/wrist bursa","description":"Incision and drainage, forearm and/or wrist; bursa","date_of_service":"2026-05-10","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":"E0450","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"84311","name":"Spectrophotometry","description":"Spectrophotometry, analyte not elsewhere specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00800","name":"Anes px lwr ant abdl wal nos","description":"Anesthesia for procedures on lower anterior abdominal wall; not otherwise specified","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"A4628","name":"Oropharyngeal suction cath","description":"Oral and/or oropharyngeal suction catheter, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6890","name":"Prefab glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85247","name":"Clot factor viii multimetric","description":"Clotting; factor viii, von willebrand factor, multimetric analysis","date_of_service":"2026-05-10","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":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"84442","name":"Assay of thyroid activity","description":"Thyroxine binding globulin (tbg)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1372","name":"Oxy suppl heater for nebuliz","description":"Immersion external heater for nebulizer","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9041","name":"Injection, bortezomib, 0.1mg","description":"Injection, bortezomib, 0.1 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":557.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"21497","name":"Interdental wirg oth/thn fx","description":"Interdental wiring, for condition other than fracture","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1221.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"01120","name":"Anes px on bony pelvis","description":"Anesthesia for procedures on bony pelvis","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"26675","name":"Treat hand dislocation","description":"Closed treatment of carpometacarpal dislocation, other than thumb, with manipulation, each joint; requiring anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0592","name":"Buprenorphine hydrochloride","description":"Injection, buprenorphine hydrochloride, 0.1 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","date_of_service":"2026-05-10","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":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2110","name":"Spherocylinder 4.25d/over 6d","description":"Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"92524","name":"Behavral qualit analys voice","description":"Behavioral and qualitative analysis of voice and resonance","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3961","name":"Sewho cap design w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"57330","name":"Repair bladder-vagina lesion","description":"Closure of vesicovaginal fistula; transvesical and vaginal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21235","name":"Ear cartilage graft","description":"Graft; ear cartilage, autogenous, to nose or ear (includes obtaining graft)","date_of_service":"2026-05-10","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":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"45541","name":"Correct rectal prolapse","description":"Proctopexy (eg, for prolapse); perineal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74235","name":"Remove esophagus obstruction","description":"Removal of foreign body(s), esophageal, with use of balloon catheter, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86654","name":"Encephaltis west eqne antbdy","description":"Antibody; encephalitis, western equine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1463.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1834.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1800","name":"Propranolol injection","description":"Injection, propranolol hcl, up to 1 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2024.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27050","name":"Biopsy of sacroiliac joint","description":"Arthrotomy, with biopsy; sacroiliac joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":337.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"49400","name":"Air injection into abdomen","description":"Injection of air or contrast into peritoneal cavity (separate procedure)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1602.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"83775","name":"Assay malate dehydrogenase","description":"Malate dehydrogenase","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","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":"78216","name":"Lvr&spleen img w/vasc flow","description":"Liver and spleen imaging; with vascular flow","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00922","name":"Anes px male gent sem ves","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); seminal vesicles","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1147.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27429","name":"Reconstruction knee","description":"Ligamentous reconstruction (augmentation), knee; intra-articular (open) and extra-articular","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1398.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"82044","name":"Ur albumin semiquantitative","description":"Albumin; urine (eg, microalbumin), semiquantitative (eg, reagent strip assay)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"47610","name":"Removal of gallbladder","description":"Cholecystectomy with exploration of common duct;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1300.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","date_of_service":"2026-05-10","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":"84078","name":"Assay alkaline phosphatase","description":"Phosphatase, alkaline; heat stable (total not included)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"27840","name":"Treat ankle dislocation","description":"Closed treatment of ankle dislocation; without anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"76818","name":"Fetal biophys profile w/nst","description":"Fetal biophysical profile; with non-stress testing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"G0441","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4410","name":"Ost skn barr extnd >4 sq","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"00172","name":"Anes ntroral px rpr clft pal","description":"Anesthesia for intraoral procedures, including biopsy; repair of cleft palate","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78630","name":"Cerebrospinal fluid scan","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"31505","name":"Diagnostic laryngoscopy","description":"Laryngoscopy, indirect; diagnostic (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95950","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1110.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"28475","name":"Cltx metatarsal fx w/mnpj ea","description":"Closed treatment of metatarsal fracture; with manipulation, each","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6900","name":"Hand restorat thumb/1 finger","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"A6524","name":"G com garmnt lwr leg/ft nght","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":756.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"92270","name":"Electro-oculography w/i&r","description":"Electro-oculography with interpretation and report","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2525","name":"Th/wght bear nar m-l brim mo","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"56637","name":"Vlvctmy rad comp bi lymphad","description":"Vulvectomy, radical, complete; with bilateral inguinofemoral lymphadenectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":947.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67145","name":"Proph rta dtchmnt pc","description":"Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; photocoagulation","date_of_service":"2026-05-10","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":"95951","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"70240","name":"X-ray exam pituitary saddle","description":"Radiologic examination, sella turcica","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55535","name":"Revise spermatic cord veins","description":"Excision of varicocele or ligation of spermatic veins for varicocele; abdominal approach","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0945","name":"Belt/harness extremity","description":"Extremity belt/harness","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2499.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":518.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"58290","name":"Vag hyst complex","description":"Vaginal hysterectomy, for uterus greater than 250 g;","date_of_service":"2026-05-10","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":"A5504","name":"Diabetic shoe with wedge","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"43761","name":"Reposition gastrostomy tube","description":"Repositioning of a naso- or oro-gastric feeding tube, through the duodenum for enteric nutrition","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28585","name":"Repair foot dislocation","description":"Open treatment of talotarsal joint dislocation, includes internal fixation, when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":683.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70487","name":"Ct maxillofacial w/dye","description":"Computed tomography, maxillofacial area; with contrast material(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77293","name":"Respirator motion mgmt simul","description":"Respiratory motion management simulation (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5681","name":"Intl custm cong/latyp insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":604.76,"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":"27340","name":"Removal of kneecap bursa","description":"Excision, prepatellar bursa","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69970","name":"Remove inner ear lesion","description":"Removal of tumor, temporal bone","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64795","name":"Biopsy of nerve","description":"Biopsy of nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":893.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1002.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"35556","name":"Art byp grft fem-popliteal","description":"Bypass graft, with vein; femoral-popliteal","date_of_service":"2026-05-10","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":"78267","name":"Urea breath tst c-14 acquisj","description":"Urea breath test, c-14 (isotopic); acquisition for analysis","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"78701","name":"Kidney imaging with flow","description":"Kidney imaging morphology; with vascular flow","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"82310","name":"Assay of calcium","description":"Calcium; total","date_of_service":"2026-05-10","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":"28286","name":"Repair of hammertoe","description":"Correction, cock-up fifth toe, with plastic skin closure (eg, ruiz-mora type procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"73000","name":"X-ray exam of collar bone","description":"Radiologic examination; clavicle, complete","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6538","name":"Gc stocking full lngth 40+","description":"Gradient compression stocking, full length/chap style, 40 mmhg or greater, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83918","name":"Organic acids total quant","description":"Organic acids; total, quantitative, each specimen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":431.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"27700","name":"Revision of ankle joint","description":"Arthroplasty, ankle;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76093","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1003.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00470","name":"Anes partial rib rescj nos","description":"Anesthesia for partial rib resection; not otherwise specified","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84478","name":"Assay of triglycerides","description":"Triglycerides","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":685.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"11900","name":"Inject skin lesions </w 7","description":"Injection, intralesional; up to and including 7 lesions","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44345","name":"Revision of colostomy","description":"Revision of colostomy; complicated (reconstruction in-depth) (separate procedure)","date_of_service":"2026-05-10","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":"84450","name":"Transferase (ast) (sgot)","description":"Transferase; aspartate amino (ast) (sgot)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"70547","name":"Mr angiography neck w/o dye","description":"Magnetic resonance angiography, neck; without contrast material(s)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2820","name":"Sargramostim injection","description":"Injection, sargramostim (gm-csf), 50 mcg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6246","name":"Hydrogel drg >16<=48 in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","date_of_service":"2026-05-10","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":"L8043","name":"Upper facial prosthesis","description":"Upper facial prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J2912","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68326","name":"Revise/graft eyelid lining","description":"Conjunctivoplasty, reconstruction cul-de-sac; with conjunctival graft or extensive rearrangement","date_of_service":"2026-05-10","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":"29819","name":"Sho arthrs srg rmvl loose/fb","description":"Arthroscopy, shoulder, surgical; with removal of loose body or foreign body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8631","name":"Mcp joint repl 2 pc or more","description":"Metacarpal phalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes entire system)","date_of_service":"2026-05-10","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":"81050","name":"Urinalysis volume measure","description":"Volume measurement for timed collection, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4266","name":"Diaphragm","description":"Diaphragm for contraceptive use","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"94728","name":"Airwy resist by oscillometry","description":"Airway resistance by oscillometry","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1405","name":"O2/water vapor enrich w/heat","description":"Oxygen and water vapor enriching system with heated delivery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"55110","name":"Explore scrotum","description":"Scrotal exploration","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"78710","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26105","name":"Biopsy finger joint lining","description":"Arthrotomy with biopsy; metacarpophalangeal joint, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0481","name":"Intrpulmnry percuss vent sys","description":"Intrapulmonary percussive ventilation system and related accessories","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["95","ET"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"78593","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87190","name":"Sc std myobacteria prop meth","description":"Susceptibility studies, antimicrobial agent; mycobacteria, proportion method, each agent","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"64405","name":"Njx aa&/strd gr ocpl nrv","description":"Injection(s), anesthetic agent(s) and/or steroid; greater occipital nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":538.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82666","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76873","name":"Echograp trans r pros study","description":"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2780","name":"Oversize lens/es","description":"Oversize lens, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"82175","name":"Assay of arsenic","description":"Arsenic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"99082","name":"Unusual physician travel","description":"Unusual travel (eg, transportation and escort of patient)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"30915","name":"Ligation nasal sinus artery","description":"Ligation arteries; ethmoidal","date_of_service":"2026-05-10","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":"27415","name":"Osteochondral knee allograft","description":"Osteochondral allograft, knee, open","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1637.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4003","name":"Cast sup shoulder cast plstr","description":"Cast supplies, shoulder cast, adult (11 years +), plaster","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"83634","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2825.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"29905","name":"Subtalar arthro w/exc","description":"Arthroscopy, subtalar joint, surgical; with synovectomy","date_of_service":"2026-05-10","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":"57505","name":"Endocervical curettage","description":"Endocervical curettage (not done as part of a dilation and curettage)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69105","name":"Biopsy of external ear canal","description":"Biopsy external auditory canal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1816.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6033","name":"Part handfing acrylic","description":"Addition to upper extremity prosthesis, partial hand including fingers, acrylic material","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2025.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23550","name":"Optx acromclv dislc aqt/chrn","description":"Open treatment of acromioclavicular dislocation, acute or chronic;","date_of_service":"2026-05-10","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":"67028","name":"Injection eye drug","description":"Intravitreal injection of a pharmacologic agent (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1657.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"Q2011","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6697","name":"Cus elbo skt in not con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"50600","name":"Exploration of ureter","description":"Ureterotomy with exploration or drainage (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6536","name":"Gc stocking full lngth 18-30","description":"Gradient compression stocking, full length/chap style, 18-30 mmhg, each","date_of_service":"2026-05-10","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":"67413","name":"Explore/treat eye socket","description":"Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of foreign body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78230","name":"Salivary gland imaging","description":"Salivary gland imaging;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75791","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58558","name":"Hysteroscopy biopsy","description":"Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without d & c","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6030","name":"External frame part handfing","description":"Upper extremity addition, external frame, partial hand including fingers","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":754.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78278","name":"Acute gi blood loss imaging","description":"Acute gastrointestinal blood loss imaging","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85611","name":"Prothrombin test","description":"Prothrombin time; substitution, plasma fractions, each","date_of_service":"2026-05-10","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":"56640","name":"Vlvctmy rad comp w/lymphadec","description":"Vulvectomy, radical, complete, with inguinofemoral, iliac, and pelvic lymphadenectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67882","name":"Revision of eyelid","description":"Construction of intermarginal adhesions, median tarsorrhaphy, or canthorrhaphy; with transposition of tarsal plate","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75968","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2425.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"J0970","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6586","name":"Elbow fair lead cable dir fo","description":"Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25907","name":"Amputation follow-up surgery","description":"Amputation, forearm, through radius and ulna; secondary closure or scar revision","date_of_service":"2026-05-10","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":"15831","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1004.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31785","name":"Remove windpipe lesion","description":"Excision of tracheal tumor or carcinoma; cervical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38242","name":"Transplt allo lymphocytes","description":"Allogeneic lymphocyte infusions","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3552.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7626","name":"Budesonide non-comp unit","description":"Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"15330","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"47122","name":"Extensive removal of liver","description":"Hepatectomy, resection of liver; trisegmentectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3720.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70491","name":"Ct soft tissue neck w/dye","description":"Computed tomography, soft tissue neck; with contrast material(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56634","name":"Vlvctmy rad comp uni lymphad","description":"Vulvectomy, radical, complete; with unilateral inguinofemoral lymphadenectomy","date_of_service":"2026-05-10","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":"J1565","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6712","name":"Ped term dev, hook, vol clos","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26518","name":"Fusion of knuckle joints","description":"Capsulodesis, metacarpophalangeal joint; 3 or 4 digits","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"56625","name":"Vulvectomy simple complete","description":"Vulvectomy simple; complete","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0484","name":"Tlso rigid plastic cust fab","description":"Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by ov","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0639","name":"Moveable patient lift system","description":"Patient lift, moveable from room to room with disassembly and reassembly, includes all components/accessories","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"92610","name":"Evaluate swallowing function","description":"Evaluation of oral and pharyngeal swallowing function","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42725","name":"I&d absc phrngl xtrnl appr","description":"Incision and drainage abscess; retropharyngeal or parapharyngeal, external approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22855","name":"Removal anterior instrmj","description":"Removal of anterior instrumentation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1300.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1991.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"34520","name":"Cross-over vein graft","description":"Cross-over vein graft to venous system","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"B9004","name":"Parenteral infus pump portab","description":"Parenteral nutrition infusion pump, portable","date_of_service":"2026-05-10","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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28495","name":"Treat big toe fracture","description":"Closed treatment of fracture great toe, phalanx or phalanges; with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58670","name":"Laparoscopy tubal cautery","description":"Laparoscopy, surgical; with fulguration of oviducts (with or without transection)","date_of_service":"2026-05-10","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":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"32604","name":"Thoracoscopy wbx sac","description":"Thoracoscopy, diagnostic (separate procedure); pericardial sac, with biopsy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67830","name":"Revise eyelashes","description":"Correction of trichiasis; incision of lid margin","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"98941","name":"Chiropract manj 3-4 regions","description":"Chiropractic manipulative treatment (cmt); spinal, 3-4 regions","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2788","name":"Rho d immune globulin 50 mcg","description":"Injection, rho d immune globulin, human, minidose, 50 micrograms (250 i.u.)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29130","name":"Appl finger splint static","description":"Application of finger splint; static","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"31020","name":"Exploration maxillary sinus","description":"Sinusotomy, maxillary (antrotomy); intranasal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59820","name":"Care of miscarriage","description":"Treatment of missed abortion, completed surgically; first trimester","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q2003","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A6235","name":"Hydrocolld drg >16<=48 w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4224","name":"Supply insulin inf cath/wk","description":"Supplies for maintenance of insulin infusion catheter, per week","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90381","name":"Rsv monoc antb seasn 1 ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 1 ml dosage, for intramuscular use","date_of_service":"2026-05-10","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":678.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"85301","name":"Antithrombin iii antigen","description":"Clotting inhibitors or anticoagulants; antithrombin iii, antigen assay","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5210","name":"No knee/ankle joints w/ ft b","description":"Above knee, short prosthesis, no knee joint (stubbies), with foot blocks, no ankle joints, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":955.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1204.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5822","name":"Endo knee-shin pneum swg frc","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-05-10","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":"78350","name":"Bone mineral single photon","description":"Bone density (bone mineral content) study, 1 or more sites; single photon absorptiometry","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76380","name":"Cat scan follow-up study","description":"Computed tomography, limited or localized follow-up study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85549","name":"Muramidase","description":"Muramidase","date_of_service":"2026-05-10","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":"72285","name":"Discography cerv/thor spine","description":"Discography, cervical or thoracic, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"40530","name":"Partial removal of lip","description":"Resection of lip, more than one-fourth, without reconstruction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0720","name":"Tens two lead","description":"Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation","date_of_service":"2026-05-10","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":"88188","name":"Flowcytometry/read 9-15","description":"Flow cytometry, interpretation; 9 to 15 markers","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0439","name":"Stationary liquid 02","description":"Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["QB","RR","QF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3976","name":"Sewhfo airplane w/o jnts cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75807","name":"Lymph vessel x-ray trunk","description":"Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73542","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53600","name":"Dilate urethra stricture","description":"Dilation of urethral stricture by passage of sound or urethral dilator, male; initial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24498","name":"Proph tx w/wo mthylmthcrylt","description":"Prophylactic treatment (nailing, pinning, plating or wiring), with or without methylmethacrylate, humeral shaft","date_of_service":"2026-05-10","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":"62143","name":"Rpl b1 flp/prostc plate skl","description":"Replacement of bone flap or prosthetic plate of skull","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"74415","name":"Urography nfs drip&/bls w/nf","description":"Urography, infusion, drip technique and/or bolus technique; with nephrotomography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63276","name":"Bx/exc xdrl spine lesn thrc","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, thoracic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24366","name":"Reconstruct head of radius","description":"Arthroplasty, radial head; with implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95907","name":"Nvr cndj tst 1-2 studies","description":"Nerve conduction studies; 1-2 studies","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1845","name":"Ko double upright pre cst","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36831","name":"Open thrombect av fistula","description":"Thrombectomy, open, arteriovenous fistula without revision, autogenous or nonautogenous dialysis graft (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67915","name":"Repair eyelid defect","description":"Repair of ectropion; thermocauterization","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74190","name":"Peritoneogram rs&i","description":"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82043","name":"Ur albumin quantitative","description":"Albumin; urine (eg, microalbumin), quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78464","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2209","name":"Lens sphcy bifocal 4.25-7/4.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":332.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28737","name":"Revision of foot bones","description":"Arthrodesis, with tendon lengthening and advancement, midtarsal, tarsal navicular-cuneiform (eg, miller type procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0982","name":"Stocking sup grips 4 pre ots","description":"Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"82947","name":"Assay glucose blood quant","description":"Glucose; quantitative, blood (except reagent strip)","date_of_service":"2026-05-10","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":"L1812","name":"Ko elastic w/joints pre ots","description":"Knee orthosis, elastic with joints, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78480","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87267","name":"Enterovirus antibody dfa","description":"Infectious agent antigen detection by immunofluorescent technique; enterovirus, direct fluorescent antibody (dfa)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G0290","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"20969","name":"Bone/skin graft microvasc","description":"Free osteocutaneous flap with microvascular anastomosis; other than iliac crest, metatarsal, or great toe","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78306","name":"Bone imaging whole body","description":"Bone and/or joint imaging; whole body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22524","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"53450","name":"Revision of urethra","description":"Urethromeatoplasty, with mucosal advancement","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0631","name":"Lso sag r an/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2005","name":"Kafo sng/dbl mechanical act","description":"Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21242","name":"Reconstruction of jaw joint","description":"Arthroplasty, temporomandibular joint, with allograft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1191.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2107","name":"Spherocylinder 4.25d/12-2d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00 sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6890","name":"Prefab glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-05-10","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":"25355","name":"Revision of radius","description":"Osteotomy, radius; middle or proximal third","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94620","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"A4932","name":"Reusable rectal thermometer","description":"Rectal thermometer, reusable, any type, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":833.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"75870","name":"Vein x-ray skull","description":"Venography, superior sagittal sinus, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0628","name":"Lso flex no ri stays pre ots","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1920.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92543","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"49650","name":"Lap ing hernia repair init","description":"Laparoscopy, surgical; repair initial inguinal hernia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52700","name":"Drainage of prostate abscess","description":"Transurethral drainage of prostatic abscess","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"96000","name":"Motion analysis video/3d","description":"Comprehensive computer-based motion analysis by video-taping and 3d kinematics;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q0482","name":"Microprcsr cu combo vad, rep","description":"Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82728","name":"Assay of ferritin","description":"Ferritin","date_of_service":"2026-05-10","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":"M0239","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"78215","name":"Lvr&spleen img static only","description":"Liver and spleen imaging; static only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75840","name":"Vein x-ray adrenal gland","description":"Venography, adrenal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"33970","name":"Aortic circulation assist","description":"Insertion of intra-aortic balloon assist device through the femoral artery, open approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":862.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"29827","name":"Sho arthrs srg rt8tr cuf rpr","description":"Arthroscopy, shoulder, surgical; with rotator cuff repair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36800","name":"Insertion of cannula","description":"Insertion of cannula for hemodialysis, other purpose (separate procedure); vein to vein","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","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":"20805","name":"Replant forearm complete","description":"Replantation, forearm (includes radius and ulna to radial carpal joint), complete amputation","date_of_service":"2026-05-10","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":"62143","name":"Rpl b1 flp/prostc plate skl","description":"Replacement of bone flap or prosthetic plate of skull","date_of_service":"2026-05-10","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":"49425","name":"Insert abdomen-venous drain","description":"Insertion of peritoneal-venous shunt","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1177.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"95937","name":"Neuromuscular junction test","description":"Neuromuscular junction testing (repetitive stimulation, paired stimuli), each nerve, any 1 method","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"77310","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35840","name":"Explore abdominal vessels","description":"Exploration for postoperative hemorrhage, thrombosis or infection; abdomen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1044.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73201","name":"Ct upper extremity w/dye","description":"Computed tomography, upper extremity; with contrast material(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93743","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"27614","name":"Biopsy lower leg soft tissue","description":"Biopsy, soft tissue of leg or ankle area; deep (subfascial or intramuscular)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5560","name":"Prep ak ischial plast molded","description":"Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"86225","name":"Dna antibody native","description":"Deoxyribonucleic acid (dna) antibody; native or double stranded","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67922","name":"Repair eyelid defect","description":"Repair of entropion; thermocauterization","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89310","name":"Semen analysis w/count","description":"Semen analysis; motility and count (not including huhner test)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43847","name":"Gstr rstcv px sm int rcnstj","description":"Gastric restrictive procedure, with gastric bypass for morbid obesity; with small intestine reconstruction to limit absorption","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1839.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"92287","name":"Ant sgm img ir flrscn angrph","description":"Anterior segment imaging with interpretation and report; with fluorescein angiography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2320","name":"Lens trifocal add over 3.25d","description":"Trifocal add over 3.25d","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0423","name":"Intens cardiac rehab no exer","description":"Intensive cardiac rehabilitation; with or without continuous ecg monitoring; without exercise, per session","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86787","name":"Varicella-zoster antibody","description":"Antibody; varicella-zoster","date_of_service":"2026-05-10","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":"L5856","name":"Elec knee-shin swing/stance","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"78011","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"79200","name":"Nuclear rx intracav admin","description":"Radiopharmaceutical therapy, by intracavitary administration","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27702","name":"Reconstruct ankle joint","description":"Arthroplasty, ankle; with implant (total ankle)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1209.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"69401","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":963.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"64702","name":"Revise finger/toe nerve","description":"Neuroplasty; digital, 1 or both, same digit","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01622","name":"Anes dx arthr px shoulder jt","description":"Anesthesia for diagnostic arthroscopic procedures of shoulder joint","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"35494","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","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":"38530","name":"Biopsy/removal lymph nodes","description":"Biopsy or excision of lymph node(s); open, internal mammary node(s)","date_of_service":"2026-05-10","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":"L6586","name":"Elbow fair lead cable dir fo","description":"Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66920","name":"Extraction of lens","description":"Removal of lens material; intracapsular","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15792","name":"Chem peel nonfacial epidrm","description":"Chemical peel, nonfacial; epidermal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24150","name":"Rad rescj tum dstl/shft hum","description":"Radical resection of tumor, shaft or distal humerus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1220.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"69960","name":"Release inner ear canal","description":"Decompression internal auditory canal","date_of_service":"2026-05-10","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":"85576","name":"Blood platelet aggregation","description":"Platelet, aggregation (in vitro), each agent","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74305","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1784.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23020","name":"Capsular contracture release","description":"Capsular contracture release (eg, sever type procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":823.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":951.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54450","name":"Preputial stretching","description":"Foreskin manipulation including lysis of preputial adhesions and stretching","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1302.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":771.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0622","name":"Sio flex pelvisacral custom","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9045","name":"Albumin (human), 5%, 250 ml","description":"Infusion, albumin (human), 5%, 250 ml","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"43340","name":"Fuse esophagus & intestine","description":"Esophagojejunostomy (without total gastrectomy); abdominal approach","date_of_service":"2026-05-10","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":"15776","name":"Hair trnspl >15 punch grafts","description":"Punch graft for hair transplant; more than 15 punch grafts","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2808.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP12","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"19350","name":"Nipple/areola reconstruction","description":"Nipple/areola reconstruction","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-10","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":"83605","name":"Assay of lactic acid","description":"Lactate (lactic acid)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01420","name":"Anes cst appl rmv/rpr kne jt","description":"Anesthesia for all cast applications, removal, or repair involving knee joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7190","name":"Elbow adolescent myoelectron","description":"Electronic elbow, adolescent, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4997.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68770","name":"Close tear system fistula","description":"Closure of lacrimal fistula (separate procedure)","date_of_service":"2026-05-10","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":"L1844","name":"Ko w/adj jt rot cntrl molded","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"43281","name":"Lap paraesophag hern repair","description":"Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; without implantation of mesh","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2105","name":"Spherocylinder 4.00d/4.25-6d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44300","name":"Open bowel to skin","description":"Placement, enterostomy or cecostomy, tube open (eg, for feeding or decompression) (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67975","name":"Reconstruction of eyelid","description":"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; second stage","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29844","name":"Wrist arthroscopy/surgery","description":"Arthroscopy, wrist, surgical; synovectomy, partial","date_of_service":"2026-05-10","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":"L5460","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"90467","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"43761","name":"Reposition gastrostomy tube","description":"Repositioning of a naso- or oro-gastric feeding tube, through the duodenum for enteric nutrition","date_of_service":"2026-05-10","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":"78104","name":"Bone marrow imaging body","description":"Bone marrow imaging; whole body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"33681","name":"Closure 1 vsd w/wo patch","description":"Closure of single ventricular septal defect, with or without patch;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44603","name":"Suture small intestine","description":"Suture of small intestine (enterorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture; multiple perforations","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1258.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01190","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":876.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20000","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["26"]}],"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":"2026-05-10","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":"73010","name":"X-ray exam of shoulder blade","description":"Radiologic examination; scapula, complete","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0452","name":"Tlso flex custom fab thoraci","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"59012","name":"Fetal cord puncture prenatal","description":"Cordocentesis (intrauterine), any method","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40500","name":"Partial excision of lip","description":"Vermilionectomy (lip shave), with mucosal advancement","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L4080","name":"Repl met band kafo-afo prox","description":"Replace metal bands kafo, proximal thigh","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01360","name":"Anes open px lower 1/3 femur","description":"Anesthesia for all open procedures on lower one-third of femur","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"60210","name":"Partial thyroid excision","description":"Partial thyroid lobectomy, unilateral; with or without isthmusectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94370","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2040","name":"Hkafo torsion bil rot straps","description":"Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"21125","name":"Augmentation mndblr prostc","description":"Augmentation, mandibular body or angle; prosthetic material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2783","name":"Lens, >= 1.66 p/>=1.80 g","description":"Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"64566","name":"Neuroeltrd stim post tibial","description":"Posterior tibial neurostimulation, percutaneous needle electrode, single treatment, includes programming","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28755","name":"Fusion of big toe joint","description":"Arthrodesis, great toe; interphalangeal joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74018","name":"Radex abdomen 1 view","description":"Radiologic examination, abdomen; 1 view","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"76948","name":"Echo guide ova aspiration","description":"Ultrasonic guidance for aspiration of ova, imaging supervision and interpretation","date_of_service":"2026-05-10","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":"B4088","name":"Gastro/jejuno tube, low-pro","description":"Gastrostomy/jejunostomy tube, low-profile, any material, any type, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":514.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78610","name":"Brain flow imaging only","description":"Brain imaging, vascular flow only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"23570","name":"Cltx scapular fx w/o mnpj","description":"Closed treatment of scapular fracture; without manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33968","name":"Remove aortic assist device","description":"Removal of intra-aortic balloon assist device, percutaneous","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"76001","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82554","name":"Creatine isoforms","description":"Creatine kinase (ck), (cpk); isoforms","date_of_service":"2026-05-10","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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0735","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"29861","name":"Hip arthro w/fb removal","description":"Arthroscopy, hip, surgical; with removal of loose body or foreign body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01420","name":"Anes cst appl rmv/rpr kne jt","description":"Anesthesia for all cast applications, removal, or repair involving knee joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"G6008","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62267","name":"Interdiscal perq aspir dx","description":"Percutaneous aspiration within the nucleus pulposus, intervertebral disc, or paravertebral tissue for diagnostic purposes","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"76827","name":"Echo exam of fetal heart","description":"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2715","name":"Prism lens/es","description":"Prism, per lens","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"87190","name":"Sc std myobacteria prop meth","description":"Susceptibility studies, antimicrobial agent; mycobacteria, proportion method, each agent","date_of_service":"2026-05-10","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":"63268","name":"Excise intrspinl lesion scrl","description":"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; sacral","date_of_service":"2026-05-10","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":"0001A","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00842","name":"Anes iper px amniocentesis","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; amniocentesis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"11451","name":"Exc skn hdrdnt ax complex","description":"Excision of skin and subcutaneous tissue for hidradenitis, axillary; with complex repair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82488","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1413.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19396","name":"Design custom breast implant","description":"Preparation of moulage for custom breast implant","date_of_service":"2026-05-10","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":"E1295","name":"Wheelchair heavy duty fixed","description":"Heavy duty wheelchair, fixed full length arms, elevating legrest","date_of_service":"2026-05-10","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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"23330","name":"Remove shoulder foreign body","description":"Removal of foreign body, shoulder; subcutaneous","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2049.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99299","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0585","name":"Nebulizer w/ compressor & he","description":"Nebulizer, with compressor and heater","date_of_service":"2026-05-10","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":"82646","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"11971","name":"Rmvl tis xpndr wo insj implt","description":"Removal of tissue expander without insertion of implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27335","name":"Remove knee joint lining","description":"Arthrotomy, with synovectomy, knee; anterior and posterior including popliteal area","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":912.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4415","name":"Ost skn barr w/o conv >4 sqi","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1133.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-10","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":"30545","name":"Rpr choanal atresia trsnpltn","description":"Repair choanal atresia; transpalatine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":725.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1499","name":"Spinal orthosis nos","description":"Spinal orthosis, not otherwise specified","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"57200","name":"Repair of vagina","description":"Colporrhaphy, suture of injury of vagina (nonobstetrical)","date_of_service":"2026-05-10","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":"77066","name":"Dx mammo incl cad bi","description":"Diagnostic mammography, including computer-aided detection (cad) when performed; bilateral","date_of_service":"2026-05-10","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":"51102","name":"Drain bl w/cath insertion","description":"Aspiration of bladder; with insertion of suprapubic catheter","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":890.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2109","name":"Spherocylinder 4.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3050","name":"Foot arch supp premold metat","description":"Foot, arch support, removable, premolded, metatarsal, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J2995","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2344.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87491","name":"Chlmyd trach dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis, amplified probe technique","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L6675","name":"Harness figure of 8 sing con","description":"Upper extremity addition, harness, (e.g., figure of eight type), single cable design","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82374","name":"Assay blood carbon dioxide","description":"Carbon dioxide (bicarbonate)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2173.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-10","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":"24430","name":"Rpr non/mal humerus wo graft","description":"Repair of nonunion or malunion, humerus; without graft (eg, compression technique)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1127.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"65400","name":"Removal of eye lesion","description":"Excision of lesion, cornea (keratectomy, lamellar, partial), except pterygium","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":556.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1793.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"21060","name":"Remove jaw joint cartilage","description":"Meniscectomy, partial or complete, temporomandibular joint (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86357","name":"Nk cells total count","description":"Natural killer (nk) cells, total count","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"95875","name":"Limb exercise test","description":"Ischemic limb exercise test with serial specimen(s) acquisition for muscle(s) metabolite(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3980","name":"Up ext fx orthos humeral nos","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":"27087","name":"Remove hip foreign body","description":"Removal of foreign body, pelvis or hip; deep (subfascial or intramuscular)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"15340","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"63197","name":"Lam w/cordotomy 1stg thrc","description":"Laminectomy with cordotomy, with section of both spinothalamic tracts, 1 stage, thoracic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3465","name":"Shoe heel thomas with wedge","description":"Heel, thomas with wedge","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51845","name":"Repair bladder neck","description":"Abdomino-vaginal vesical neck suspension, with or without endoscopic control (eg, stamey, raz, modified pereyra)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0127","name":"Trim nail(s)","description":"Trimming of dystrophic nails, any number","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0574","name":"Ultrasonic generator w svneb","description":"Ultrasonic/electronic aerosol generator with small volume nebulizer","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84081","name":"Assay phosphatidylglycerol","description":"Phosphatidylglycerol","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99326","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46250","name":"Remove ext hem groups 2+","description":"Hemorrhoidectomy, external, 2 or more columns/groups","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":884.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57510","name":"Cauterization of cervix","description":"Cautery of cervix; electro or thermal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77065","name":"Dx mammo incl cad uni","description":"Diagnostic mammography, including computer-aided detection (cad) when performed; unilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0010","name":"Stnd wt frame power whlchr","description":"Standard - weight frame motorized/power wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71022","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69603","name":"Revj mstdc rsltg rad mstdc","description":"Revision mastoidectomy; resulting in radical mastoidectomy","date_of_service":"2026-05-10","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":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35226","name":"Repair blood vessel dir lxtr","description":"Repair blood vessel, direct; lower extremity","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1072.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"88366","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11980","name":"Implant hormone pellet(s)","description":"Subcutaneous hormone pellet implantation (implantation of estradiol and/or testosterone pellets beneath the skin)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"92140","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0779","name":"Amb infusion pump mechanical","description":"Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73560","name":"X-ray exam of knee 1 or 2","description":"Radiologic examination, knee; 1 or 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01622","name":"Anes dx arthr px shoulder jt","description":"Anesthesia for diagnostic arthroscopic procedures of shoulder joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"85525","name":"Heparin neutralization","description":"Heparin neutralization","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","date_of_service":"2026-05-10","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":"45520","name":"Treatment of rectal prolapse","description":"Perirectal injection of sclerosing solution for prolapse","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":726.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":377.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75982","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"64475","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"29405","name":"Appl short leg cast","description":"Application of short leg cast (below knee to toes);","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91011","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J3487","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1083","name":"Hemi-wheelchair fixed arms","description":"Hemi-wheelchair, fixed full length arms, swing away detachable elevating leg rest","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92071","name":"Contact lens fitting for tx","description":"Fitting of contact lens for treatment of ocular surface disease","date_of_service":"2026-05-10","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":"31085","name":"Removal of frontal sinus","description":"Sinusotomy frontal; obliterative, with osteoplastic flap, coronal incision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1353.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5722","name":"Knee-shin pneum swg frct exo","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"28103","name":"Remove/graft foot lesion","description":"Excision or curettage of bone cyst or benign tumor, talus or calcaneus; with allograft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75605","name":"Contrast exam thoracic aorta","description":"Aortography, thoracic, by serialography, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"00210","name":"Anes intracranial px nos","description":"Anesthesia for intracranial procedures; not otherwise specified","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19357","name":"Tiss xpndr plmt brst rcnstj","description":"Tissue expander placement in breast reconstruction, including subsequent expansion(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4236","name":"Silvr oxide batt glucose mon","description":"Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37214","name":"Cessj therapy cath removal","description":"Transcatheter therapy, arterial or venous infusion for thrombolysis other than coronary, any method, including radiological supervision and interpretation, continued treatment on subsequent day during course of thrombolytic therapy, including follow-up catheter contrast injection, position change, o","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"47570","name":"Laparo cholecystoenterostomy","description":"Laparoscopy, surgical; cholecystoenterostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":871.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"27792","name":"Treatment of ankle fracture","description":"Open treatment of distal fibular fracture (lateral malleolus), includes internal fixation, when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95864","name":"Needle emg 4 extremities","description":"Needle electromyography; 4 extremities with or without related paraspinal areas","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6920","name":"Wrist disarticul switch ctrl","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-10","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":"88323","name":"Consltj&reprt matrl prep sld","description":"Consultation and report on referred material requiring preparation of slides","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"41520","name":"Reconstruction tongue fold","description":"Frenoplasty (surgical revision of frenum, eg, with z-plasty)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6222","name":"Gauze <=16 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77750","name":"Infuse radioactive materials","description":"Infusion or instillation of radioelement solution (includes 3-month follow-up care)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"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":"84590","name":"Assay of vitamin a","description":"Vitamin a","date_of_service":"2026-05-10","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":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"11981","name":"Insertion drug dlvr implant","description":"Insertion, drug-delivery implant (ie, bioresorbable, biodegradable, non-biodegradable)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"V2310","name":"Lens sphc trifocal 4.25-7/>6","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":682.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2364.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22830","name":"Exploration of spinal fusion","description":"Exploration of spinal fusion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33464","name":"Valvuloplasty tricuspid","description":"Valvuloplasty, tricuspid valve; with ring insertion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2012.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1222","name":"Wheelchair spec size w/ leg","description":"Wheelchair with fixed arm, elevating legrests","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KL"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L0628","name":"Lso flex no ri stays pre ots","description":"Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"82975","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"32654","name":"Thoracoscopy contrl bleeding","description":"Thoracoscopy, surgical; with control of traumatic hemorrhage","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":969.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"E1298","name":"Wheelchair spec seat depth/w","description":"Special wheelchair seat depth and/or width, by construction","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"78610","name":"Brain flow imaging only","description":"Brain imaging, vascular flow only","date_of_service":"2026-05-10","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":"32445","name":"Removal of lung extrapleural","description":"Removal of lung, pneumonectomy; extrapleural","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2839.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49904","name":"Omental flap extra-abdom","description":"Omental flap, extra-abdominal (eg, for reconstruction of sternal and chest wall defects)","date_of_service":"2026-05-10","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":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28005","name":"Treat foot bone lesion","description":"Incision, bone cortex (eg, osteomyelitis or bone abscess), foot","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":717.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74400","name":"Urography iv +-kub tomog","description":"Urography (pyelography), intravenous, with or without kub, with or without tomography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","date_of_service":"2026-05-10","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":"77052","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"55866","name":"Laps surg prst8ect rpbic rad","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1939.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"32940","name":"Revision of lung","description":"Pneumonolysis, extraperiosteal, including filling or packing procedures","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23071","name":"Exc shoulder les sc 3 cm/>","description":"Excision, tumor, soft tissue of shoulder area, subcutaneous; 3 cm or greater","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2204","name":"Lens sphcy bifocal 4.00d/2.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-10","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":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"66825","name":"Reposition intraocular lens","description":"Repositioning of intraocular lens prosthesis, requiring an incision (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2082.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44155","name":"Removal of colon/ileostomy","description":"Colectomy, total, abdominal, with proctectomy; with ileostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1974.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"86781","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"74249","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2126.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1289.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58660","name":"Laparoscopy lysis","description":"Laparoscopy, surgical; with lysis of adhesions (salpingolysis, ovariolysis) (separate procedure)","date_of_service":"2026-05-10","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":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5150","name":"Mold sckt ext knee shin sach","description":"Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1011.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57220","name":"Revision of urethra","description":"Plastic operation on urethral sphincter, vaginal approach (eg, kelly urethral plication)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"57112","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"33244","name":"Remove elctrd transvenously","description":"Removal of single or dual chamber implantable defibrillator electrode(s); by transvenous extraction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6588","name":"Shdr fair lead cable molded","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33536","name":"Cabg arterial four or more","description":"Coronary artery bypass, using arterial graft(s); 4 or more coronary arterial grafts","date_of_service":"2026-05-10","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":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"32225","name":"Partial release of lung","description":"Decortication, pulmonary (separate procedure); partial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0606","name":"Drainage board postural","description":"Postural drainage board","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50610","name":"Removal of ureter stone","description":"Ureterolithotomy; upper one-third of ureter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77073","name":"Bone length studies","description":"Bone length studies (orthoroentgenogram, scanogram)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31570","name":"Laryngoscope w/vc inj","description":"Laryngoscopy, direct, with injection into vocal cord(s), therapeutic;","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2230.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8310","name":"Truss double w/ standard pad","description":"Truss, double with standard pads","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1020.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B9006","name":"Parenteral infus pump statio","description":"Parenteral nutrition infusion pump, stationary","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"62194","name":"Replace/irrigate catheter","description":"Replacement or irrigation, subarachnoid/subdural catheter","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"A4558","name":"Conductive gel or paste","description":"Conductive gel or paste, for use with electrical device (e.g., tens, nmes), per oz","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1231.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83880","name":"Assay of natriuretic peptide","description":"Natriuretic peptide","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32400","name":"Needle biopsy chest lining","description":"Biopsy, pleura, percutaneous needle","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6400","name":"Below elbow prosth tiss shap","description":"Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0447T","name":"Rmvl impltbl glucose sensor","description":"Removal of implantable interstitial glucose sensor from subcutaneous pocket via incision","date_of_service":"2026-05-10","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":"E0930","name":"Fracture frame free standing","description":"Fracture frame, free standing, includes weights","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"L0810","name":"Halo cervical into jckt vest","description":"Halo procedure, cervical halo incorporated into jacket vest","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00566","name":"Anes direct cabg w/o pump","description":"Anesthesia for direct coronary artery bypass grafting; without pump oxygenator","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":518.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1242.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"23420","name":"Repair of shoulder","description":"Reconstruction of complete shoulder (rotator) cuff avulsion, chronic (includes acromioplasty)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1207.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27707","name":"Osteotomy fibula","description":"Osteotomy; fibula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":462.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"93544","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4719","name":"Y set tubing","description":"Y set tubing for peritoneal dialysis","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"73000","name":"X-ray exam of collar bone","description":"Radiologic examination; clavicle, complete","date_of_service":"2026-05-10","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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99408","name":"Audit/dast 15-30 min","description":"Alcohol and/or substance (other than tobacco) abuse structured screening (eg, audit, dast), and brief intervention (sbi) services; 15 to 30 minutes","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63191","name":"Incise spine accessory nerve","description":"Laminectomy with section of spinal accessory nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1255.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77783","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1265.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"ATP09","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":"29450","name":"Application clubfoot cast","description":"Application of clubfoot cast with molding or manipulation, long or short leg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2783","name":"Lens, >= 1.66 p/>=1.80 g","description":"Lens, index greater than or equal to 1.66 plastic or greater than or equal to 1.80 glass, excludes polycarbonate, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0236","name":"Pump for water circulating p","description":"Pump for water circulating pad","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72020","name":"X-ray exam of spine 1 view","description":"Radiologic examination, spine, single view, specify level","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27418","name":"Repair degenerated kneecap","description":"Anterior tibial tubercleplasty (eg, maquet type procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":988.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78582","name":"Lung ventilat&perfus imaging","description":"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82963","name":"Assay of glucosidase","description":"Glucosidase, beta","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-10","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":"34401","name":"Removal of vein clot","description":"Thrombectomy, direct or with catheter; vena cava, iliac vein, by abdominal incision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53442","name":"Remove/revise male sling","description":"Removal or revision of sling for male urinary incontinence (eg, fascia or synthetic)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":634.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32420","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86379","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"60505","name":"Explore parathyroid glands","description":"Parathyroidectomy or exploration of parathyroid(s); with mediastinal exploration, sternal split or transthoracic approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5818","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"31660","name":"Bronch thermoplsty 1 lobe","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial thermoplasty, 1 lobe","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71023","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-10","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":"93888","name":"Intracranial limited study","description":"Transcranial doppler study of the intracranial arteries; limited study","date_of_service":"2026-05-10","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":"28001","name":"Drainage of bursa of foot","description":"Incision and drainage, bursa, foot","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83002","name":"Assay of gonadotropin (lh)","description":"Gonadotropin; luteinizing hormone (lh)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69535","name":"Remove part of temporal bone","description":"Resection temporal bone, external approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2141.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19342","name":"Insj/rplcmt brst implt sep d","description":"Insertion or replacement of breast implant on separate day from mastectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57284","name":"Repair paravag defect open","description":"Paravaginal defect repair (including repair of cystocele, if performed); open abdominal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":947.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"92287","name":"Ant sgm img ir flrscn angrph","description":"Anterior segment imaging with interpretation and report; with fluorescein angiography","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":"80101","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69502","name":"Mastoidectomy","description":"Mastoidectomy; complete","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":529.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"86788","name":"West nile virus ab igm","description":"Antibody; west nile virus, igm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1313.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26474","name":"Fusion of finger tendons","description":"Tenodesis; of distal joint, each joint","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"J1645","name":"Dalteparin sodium","description":"Injection, dalteparin sodium, per 2500 iu","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0279","name":"Tomosynthesis, mammo","description":"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"12020","name":"Tx supfc wnd dehsn smpl clsr","description":"Treatment of superficial wound dehiscence; simple closure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23480","name":"Revision of collar bone","description":"Osteotomy, clavicle, with or without internal fixation;","date_of_service":"2026-05-10","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":"28190","name":"Removal of foot foreign body","description":"Removal of foreign body, foot; subcutaneous","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-10","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":"33802","name":"Division aberrant vessel","description":"Division of aberrant vessel (vascular ring);","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0920","name":"Fracture frame attached to b","description":"Fracture frame, attached to bed, includes weights","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"74710","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"82528","name":"Assay of corticosterone","description":"Corticosterone","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57135","name":"Excision vaginal cyst/tumor","description":"Excision of vaginal cyst or tumor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1157.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5616","name":"Ak univ multiplex sys frict","description":"Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4315","name":"Cath w/drainage 2-way silcne","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77051","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"62302","name":"Myelography lumbar injection","description":"Myelography via lumbar injection, including radiological supervision and interpretation; cervical","date_of_service":"2026-05-10","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":"E0300","name":"Enclosed ped crib hosp grade","description":"Pediatric crib, hospital grade, fully enclosed, with or without top enclosure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L4631","name":"Afo, walk boot type, cus fab","description":"Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20974","name":"Estim aid bone healg n-invas","description":"Electrical stimulation to aid bone healing; noninvasive (nonoperative)","date_of_service":"2026-05-10","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":"Q0163","name":"Diphenhydramine hcl 50mg","description":"Diphenhydramine hydrochloride, 50 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at time of chemotherapy treatment not to exceed a 48 hour dosage regimen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2173.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q2008","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1925.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":890.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"67440","name":"Explore/drain eye socket","description":"Orbitotomy with bone flap or window, lateral approach (eg, kroenlein); with drainage","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1261.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85291","name":"Clot factor xiii fibrin scrn","description":"Clotting; factor xiii (fibrin stabilizing), screen solubility","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2058.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"A4391","name":"Urinary pouch w ex wear barr","description":"Ostomy pouch, urinary, with extended wear barrier attached (1 piece), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"33860","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28645","name":"Repair toe dislocation","description":"Open treatment of metatarsophalangeal joint dislocation, includes internal fixation, when performed","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"P7001","name":"Culture bacterial urine","description":"Culture, bacterial, urine; quantitative, sensitivity study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"32655","name":"Thoracoscopy resect bullae","description":"Thoracoscopy, surgical; with resection-plication of bullae, includes any pleural procedure when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-05-10","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":"52320","name":"Cystoscopy and treatment","description":"Cystourethroscopy (including ureteral catheterization); with removal of ureteral calculus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0190T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27122","name":"Reconstruction of hip socket","description":"Acetabuloplasty; resection, femoral head (eg, girdlestone procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46730","name":"Construction of absent anus","description":"Repair of high imperforate anus without fistula; perineal or sacroperineal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1815.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37650","name":"Ligation of femoral vein","description":"Ligation of femoral vein","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":402.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"19303","name":"Mast simple complete","description":"Mastectomy, simple, complete","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":642.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1286.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"48511","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":778.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78428","name":"Cardiac shunt imaging","description":"Cardiac shunt detection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A6587","name":"Grad com wrap w straps foot","description":"Gradient compression wrap with adjustable straps, foot, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"38120","name":"Laparoscopy splenectomy","description":"Laparoscopy, surgical, splenectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32002","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4429","name":"Urine ost pouch w bltinconv","description":"Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"A6243","name":"Hydrogel drg >16<=48 w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","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":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1631.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KF"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"60225","name":"Partial removal of thyroid","description":"Total thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1034.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1549.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":607.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":946.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":845.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0205","name":"Heat lamp with stand","description":"Heat lamp, with stand, includes bulb, or infrared element","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"64732","name":"Incision of brow nerve","description":"Transection or avulsion of; supraorbital nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"44120","name":"Removal of small intestine","description":"Enterectomy, resection of small intestine; single resection and anastomosis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1169.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q0114","name":"Fern test","description":"Fern test","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"36014","name":"Place catheter in artery","description":"Selective catheter placement, left or right pulmonary artery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7034","name":"Nasal application device","description":"Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A5505","name":"Diab shoe w/metatarsal bar","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7499","name":"Upper extremity prosthes nos","description":"Upper extremity prosthesis, not otherwise specified","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0010","name":"Stnd wt frame power whlchr","description":"Standard - weight frame motorized/power wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"24130","name":"Excision radial head","description":"Excision, radial head","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"42845","name":"Extensive surgery of throat","description":"Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; closure with other flap","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36140","name":"Intro ndl icath upr/lxtr art","description":"Introduction of needle or intracatheter, upper or lower extremity artery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"31080","name":"Removal of frontal sinus","description":"Sinusotomy frontal; obliterative without osteoplastic flap, brow incision (includes ablation)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"58940","name":"Removal of ovary(s)","description":"Oophorectomy, partial or total, unilateral or bilateral;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":549.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"46030","name":"Removal anal seton oth mrk","description":"Removal of anal seton, other marker","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"79445","name":"Nuclear rx intra-arterial","description":"Radiopharmaceutical therapy, by intra-arterial particulate administration","date_of_service":"2026-05-10","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":"L6500","name":"Above elbow prosth tiss shap","description":"Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"26070","name":"Explore/treat hand joint","description":"Arthrotomy, with exploration, drainage, or removal of loose or foreign body; carpometacarpal joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29010","name":"Appl risser jacket body only","description":"Application of risser jacket, localizer, body; only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5507","name":"Modification diabetic shoe","description":"For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"31590","name":"Reinnervate larynx","description":"Laryngeal reinnervation by neuromuscular pedicle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1078.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"93970","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44701","name":"Intraop colon lavage add-on","description":"Intraoperative colonic lavage (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73701","name":"Ct lower extremity w/dye","description":"Computed tomography, lower extremity; with contrast material(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6220","name":"Gauze >16 <=48 sq in w/bordr","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1279.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":467.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A6539","name":"Gc stocking waistlngth 18-30","description":"Gradient compression stocking, waist length, 18-30 mmhg, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31635","name":"Bronchoscopy w/fb removal","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal of foreign body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01380","name":"Anes all clsd px knee joint","description":"Anesthesia for all closed procedures on knee joint","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1539.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A7046","name":"Repl water chamber, pap dev","description":"Water chamber for humidifier, used with positive airway pressure device, replacement, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35515","name":"Art byp grft subclav-vertbrl","description":"Bypass graft, with vein; subclavian-vertebral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J1885","name":"Ketorolac tromethamine inj","description":"Injection, ketorolac tromethamine, per 15 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2173.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2010","name":"Kafo sng solid stirrup w/o j","description":"Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), without knee joint, custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":574.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J9095","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4629","name":"Tracheostomy care kit","description":"Tracheostomy care kit for established tracheostomy","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"70548","name":"Mr angiography neck w/dye","description":"Magnetic resonance angiography, neck; with contrast material(s)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26170","name":"Removal of palm tendon each","description":"Excision of tendon, palm, flexor or extensor, single, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61330","name":"Dcmprn orbit only transcrnl","description":"Decompression of orbit only, transcranial approach","date_of_service":"2026-05-10","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":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1036","name":"Patient transfer system >300","description":"Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20663","name":"Application halo femoral","description":"Application of halo, including removal; femoral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":267.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5781","name":"Lower limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":984.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0200","name":"Cerv col supp adj bar & thor","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars, and thoracic extension","date_of_service":"2026-05-10","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":"41872","name":"Gingivoplasty each quadrant","description":"Gingivoplasty, each quadrant (specify)","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"78596","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74176","name":"Ct abd & pelvis w/o contrast","description":"Computed tomography, abdomen and pelvis; without contrast material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0171T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"23460","name":"Repair shoulder capsule","description":"Capsulorrhaphy, anterior, any type; with bone block","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1340.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4351","name":"Straight tip urine catheter","description":"Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each","date_of_service":"2026-05-10","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":"00800","name":"Anes px lwr ant abdl wal nos","description":"Anesthesia for procedures on lower anterior abdominal wall; not otherwise specified","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"28800","name":"Amputation of midfoot","description":"Amputation, foot; midtarsal (eg, chopart type procedure)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26075","name":"Explore/treat finger joint","description":"Arthrotomy, with exploration, drainage, or removal of loose or foreign body; metacarpophalangeal joint, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35485","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"57800","name":"Dilation of cervical canal","description":"Dilation of cervical canal, instrumental (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42440","name":"Excise submaxillary gland","description":"Excision of submandibular (submaxillary) gland","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":550.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5585","name":"Prep ak ischial open end","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-10","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":"75600","name":"Contrast exam thoracic aorta","description":"Aortography, thoracic, without serialography, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50130","name":"Pyelotomy w/removal calculus","description":"Pyelotomy; with removal of calculus (pyelolithotomy, pelviolithotomy, including coagulum pyelolithotomy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24920","name":"Amputation of upper arm","description":"Amputation, arm through humerus; open, circular (guillotine)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44625","name":"Repair bowel opening","description":"Closure of enterostomy, large or small intestine; with resection and anastomosis other than colorectal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":822.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95875","name":"Limb exercise test","description":"Ischemic limb exercise test with serial specimen(s) acquisition for muscle(s) metabolite(s)","date_of_service":"2026-05-10","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":"66500","name":"Incision of iris","description":"Iridotomy by stab incision (separate procedure); except transfixion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"30140","name":"Resect inferior turbinate","description":"Submucous resection inferior turbinate, partial or complete, any method","date_of_service":"2026-05-10","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":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"54150","name":"Circumcision w/regionl block","description":"Circumcision, using clamp or other device with regional dorsal penile or ring block","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70380","name":"X-ray exam of salivary gland","description":"Radiologic examination, salivary gland for calculus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96102","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86813","name":"Hla typing a b or c","description":"Hla typing; a, b, or c, multiple antigens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":508.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2519.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70355","name":"Panoramic x-ray of jaws","description":"Orthopantogram (eg, panoramic x-ray)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"82525","name":"Assay of copper","description":"Copper","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"28825","name":"Partial amputation of toe","description":"Amputation, toe; interphalangeal joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1094.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"46753","name":"Reconstruction of anus","description":"Graft (thiersch operation) for rectal incontinence and/or prolapse","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38211","name":"Tumor cell deplete of harvst","description":"Transplant preparation of hematopoietic progenitor cells; tumor cell depletion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55450","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"01680","name":"Anes sho cast appl rmvl/rpr","description":"Anesthesia for shoulder cast application, removal or repair, not otherwise specified","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"78701","name":"Kidney imaging with flow","description":"Kidney imaging morphology; with vascular flow","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2629.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"61796","name":"Srs cranial lesion simple","description":"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 simple cranial lesion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2223","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"0466T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3635.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"90674","name":"Cciiv4 vac no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (cciiv4), derived from cell cultures, subunit, preservative and antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","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":34.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1969.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75870","name":"Vein x-ray skull","description":"Venography, superior sagittal sinus, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21123","name":"Geniop sldg augmentation","description":"Genioplasty; sliding, augmentation with interpositional bone grafts (includes obtaining autografts)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26449","name":"Release forearm/hand tendon","description":"Tenolysis, complex, extensor tendon, finger, including forearm, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31580","name":"Laryngoplasty laryngeal web","description":"Laryngoplasty; for laryngeal web, with indwelling keel or stent insertion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1328.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47785","name":"Fuse bile ducts and bowel","description":"Anastomosis, roux-en-y, of intrahepatic biliary ducts and gastrointestinal tract","date_of_service":"2026-05-10","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":"78103","name":"Bone marrow imaging mult","description":"Bone marrow imaging; multiple areas","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43264","name":"Ercp remove duct calculi","description":"Endoscopic retrograde cholangiopancreatography (ercp); with removal of calculi/debris from biliary/pancreatic duct(s)","date_of_service":"2026-05-10","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":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2398.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5053","name":"Clsd ostomy pouch faceplate","description":"Ostomy pouch, closed; for use on faceplate, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78291","name":"Pertl-ven shunt patency test","description":"Peritoneal-venous shunt patency test (eg, for leveen, denver shunt)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"T4521","name":"Adult size brief/diaper sm","description":"Adult sized disposable incontinence product, brief/diaper, small, each","date_of_service":"2026-05-10","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":"85210","name":"Clot factor ii prothrom spec","description":"Clotting; factor ii, prothrombin, specific","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","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":"E1036","name":"Patient transfer system >300","description":"Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1575.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":667.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4045","name":"Cast sup sht leg splnt plstr","description":"Cast supplies, short leg splint, adult (11 years +), plaster","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1170","name":"Whlchr ampu fxd arm leg rest","description":"Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"78230","name":"Salivary gland imaging","description":"Salivary gland imaging;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"82668","name":"Assay of erythropoietin","description":"Erythropoietin","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"58672","name":"Laparoscopy fimbrioplasty","description":"Laparoscopy, surgical; with fimbrioplasty","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-10","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":"31256","name":"Exploration maxillary sinus","description":"Nasal/sinus endoscopy, surgical, with maxillary antrostomy;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"29897","name":"Ankle arthroscopy/surgery","description":"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, limited","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":649.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-05-10","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":"26500","name":"Hand tendon reconstruction","description":"Reconstruction of tendon pulley, each tendon; with local tissues (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"36834","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":720.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"75562","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"83655","name":"Assay of lead","description":"Lead","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E3000","name":"Speech volume modulation sys","description":"Speech volume modulation system, any type, including all components and accessories","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"91000","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1555.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1103.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88289","name":"Chromosome study additional","description":"Chromosome analysis; additional high resolution study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4490","name":"Above knee surgical stocking","description":"Surgical stockings above knee length, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"87533","name":"Hhv-6 dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); herpes virus-6, quantification","date_of_service":"2026-05-10","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":"11752","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42890","name":"Limited pharyngectomy","description":"Limited pharyngectomy","date_of_service":"2026-05-10","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":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"60605","name":"Remove carotid body lesion","description":"Excision of carotid body tumor; with excision of carotid artery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1464.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2340","name":"Pre-tibial shell molded to p","description":"Addition to lower extremity, pre-tibial shell, molded to patient model","date_of_service":"2026-05-10","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":"32095","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":671.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86310","name":"Heterophile antibody absrbj","description":"Heterophile antibodies; titers after absorption with beef cells and guinea pig kidney","date_of_service":"2026-05-10","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":"78598","name":"Lung perf&ventilat diferentl","description":"Quantitative differential pulmonary perfusion and ventilation (eg, aerosol or gas), including imaging when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60520","name":"Removal of thymus gland","description":"Thymectomy, partial or total; transcervical approach (separate procedure)","date_of_service":"2026-05-10","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":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5535","name":"Prep bk ptb open end socket","description":"Preparatory, below knee ptb type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":846.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-05-10","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":"78070","name":"Parathyroid planar imaging","description":"Parathyroid planar imaging (including subtraction, when performed);","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1238","name":"Fld ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, folding, adjustable, without seating system","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"31620","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-10","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":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","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":"78761","name":"Testicular imaging w/flow","description":"Testicular imaging with vascular flow","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":962.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2425","name":"Knee disc/dial lock/adj flex","description":"Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1504.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"78278","name":"Acute gi blood loss imaging","description":"Acute gastrointestinal blood loss imaging","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83722","name":"Lipoprtn dir meas sd ldl chl","description":"Lipoprotein, direct measurement; small dense ldl cholesterol","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"43326","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52341","name":"Cysto w/ureter stricture tx","description":"Cystourethroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6580","name":"Wrist/elbow bowden cable mol","description":"Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":777.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61522","name":"Removal of brain abscess","description":"Craniectomy, infratentorial or posterior fossa; for excision of brain abscess","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"64472","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"61610","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"82520","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31613","name":"Tracheostoma revj simple","description":"Tracheostoma revision; simple, without flap rotation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76817","name":"Transvaginal us obstetric","description":"Ultrasound, pregnant uterus, real time with image documentation, transvaginal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1973.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86666","name":"Ehrlichia antibody","description":"Antibody; ehrlichia","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77470","name":"Special radiation treatment","description":"Special treatment procedure (eg, total body irradiation, hemibody radiation, per oral or endocavitary irradiation)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43192","name":"Esophagoscp rig trnso inject","description":"Esophagoscopy, rigid, transoral; with directed submucosal injection(s), any substance","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43325","name":"Revise esophagus & stomach","description":"Esophagogastric fundoplasty, with fundic patch (thal-nissen procedure)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":812.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"J2360","name":"Orphenadrine injection","description":"Injection, orphenadrine citrate, up to 60 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"84120","name":"Assay of urine porphyrins","description":"Porphyrins, urine; quantitation and fractionation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93612","name":"Intraventricular pacing","description":"Intraventricular pacing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01990","name":"Physiol support hrvg organs","description":"Physiological support for harvesting of organ(s) from brain-dead patient","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"57426","name":"Revise prosth vag graft lap","description":"Revision (including removal) of prosthetic vaginal graft, laparoscopic approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68500","name":"Removal of tear gland","description":"Excision of lacrimal gland (dacryoadenectomy), except for tumor; total","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":945.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A4932","name":"Reusable rectal thermometer","description":"Rectal thermometer, reusable, any type, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6320","name":"Shoulder passive restor cap","description":"Shoulder disarticulation, passive restoration (shoulder cap only)","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0780","name":"Prochlorperazine injection","description":"Injection, prochlorperazine, up to 10 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6611","name":"Additional switch, ext power","description":"Addition to upper extremity prosthesis, external powered, additional switch, any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26145","name":"Tendon excision palm/finger","description":"Synovectomy, tendon sheath, radical (tenosynovectomy), flexor tendon, palm and/or finger, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":608.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74400","name":"Urography iv +-kub tomog","description":"Urography (pyelography), intravenous, with or without kub, with or without tomography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0749","name":"Elec osteogen stim implanted","description":"Osteogenesis stimulator, electrical, surgically implanted","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93612","name":"Intraventricular pacing","description":"Intraventricular pacing","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"L5617","name":"Ak/bk self-aligning unit ea","description":"Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84127","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4425","name":"Ost pch drain for barrier fl","description":"Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"78580","name":"Lung perfusion imaging","description":"Pulmonary perfusion imaging (eg, particulate)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88106","name":"Cytopath fl nongyn filter","description":"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3334.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU","KF",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.6,"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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77408","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23031","name":"I&d shoulder infected bursa","description":"Incision and drainage, shoulder area; infected bursa","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01464","name":"Anes arthrs px ankle&/foot","description":"Anesthesia for arthroscopic procedures of ankle and/or foot","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"74740","name":"X-ray female genital tract","description":"Hysterosalpingography, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"90901","name":"Biofeedback train any meth","description":"Biofeedback training by any modality","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"73530","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"92135","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33415","name":"Revision subvalvular tissue","description":"Resection or incision of subvalvular tissue for discrete subvalvular aortic stenosis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1922.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"70140","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; less than 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"T4528","name":"Adult size pull-on xl","description":"Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"61795","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6532","name":"Compress stking bk40-50 surg","description":"Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2030","name":"Kafo dbl solid stirrup w/o j","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar ak orthosis), without knee joint, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2188","name":"Quadrilateral brim","description":"Addition to lower extremity fracture orthosis, quadrilateral brim","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29883","name":"Arthrs kne srg mnisc rpr m&l","description":"Arthroscopy, knee, surgical; with meniscus repair (medial and lateral)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"00902","name":"Anes anorectal px","description":"Anesthesia for; anorectal procedure","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","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":"G0515","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70015","name":"Contrast x-ray of brain","description":"Cisternography, positive contrast, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP10","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-05-10","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":"36522","name":"Photopheresis","description":"Photopheresis, extracorporeal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35266","name":"Rpr blvsl grf oth/th vn uxtr","description":"Repair blood vessel with graft other than vein; upper extremity","date_of_service":"2026-05-10","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":"15776","name":"Hair trnspl >15 punch grafts","description":"Punch graft for hair transplant; more than 15 punch grafts","date_of_service":"2026-05-10","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":"45345","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0735","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"37227","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7249.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0478T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"A4330","name":"Stool collection pouch","description":"Perianal fecal collection pouch with adhesive, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"23100","name":"Arthrotomy glenhumrl jt w/bx","description":"Arthrotomy, glenohumeral joint, including biopsy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":582.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88237","name":"Tissue culture bone marrow","description":"Tissue culture for neoplastic disorders; bone marrow, blood cells","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0345","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78469","name":"Heart infarct image (3d)","description":"Myocardial imaging, infarct avid, planar; tomographic spect with or without quantification","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4918","name":"Venous pressure clamp","description":"Venous pressure clamp, for hemodialysis, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2445.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q9949","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5614","name":"4-bar link above knee w/swng","description":"Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32556","name":"Insert cath pleura w/o image","description":"Pleural drainage, percutaneous, with insertion of indwelling catheter; without imaging guidance","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":754.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-10","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":"42720","name":"I&d absc phrngl ntraorl appr","description":"Incision and drainage abscess; retropharyngeal or parapharyngeal, intraoral approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5513","name":"Multi den insert custom mold","description":"For diabetics only, multiple density insert, custom molded from model of patients foot, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each","date_of_service":"2026-05-10","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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26607","name":"Treat metacarpal fracture","description":"Closed treatment of metacarpal fracture, with manipulation, with external fixation, each bone","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0064A","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"95958","name":"Eeg monitoring/function test","description":"Wada activation test for hemispheric function, including electroencephalographic (eeg) monitoring","date_of_service":"2026-05-10","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":"69910","name":"Remove inner ear & mastoid","description":"Labyrinthectomy; with mastoidectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":809.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91012","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"82040","name":"Assay of serum albumin","description":"Albumin; serum, plasma or whole blood","date_of_service":"2026-05-10","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":"27722","name":"Repair/graft of tibia","description":"Repair of nonunion or malunion, tibia; with sliding graft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"23400","name":"Fixation of shoulder blade","description":"Scapulopexy (eg, sprengels deformity or for paralysis)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1179.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-10","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":"22525","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3567.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2101","name":"Bld glucose monitor w lance","description":"Blood glucose monitor with integrated lancing/blood sample","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90623","name":"Menacwy-tt menb-fhbp vacc im","description":"Meningococcal pentavalent vaccine, conjugated men a, c, w, y- tetanus toxoid carrier, and men b-fhbp, for intramuscular use","date_of_service":"2026-05-10","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":286.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"G6001","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01380","name":"Anes all clsd px knee joint","description":"Anesthesia for all closed procedures on knee joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"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":"2026-05-10","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":"Q0092","name":"Set up port xray equipment","description":"Set-up portable x-ray equipment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"35654","name":"Bpg axillary-femoral-femoral","description":"Bypass graft, with other than vein; axillary-femoral-femoral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7042","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69915","name":"Incise inner ear nerve","description":"Vestibular nerve section, translabyrinthine approach","date_of_service":"2026-05-10","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":"82980","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96360","name":"Hydration iv infusion init","description":"Intravenous infusion, hydration; initial, 31 minutes to 1 hour","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75625","name":"Contrast exam abdominl aorta","description":"Aortography, abdominal, by serialography, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"40520","name":"Partial excision of lip","description":"Excision of lip; v-excision with primary direct linear closure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"76080","name":"X-ray exam of fistula","description":"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"82415","name":"Assay of chloramphenicol","description":"Chloramphenicol","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"76380","name":"Cat scan follow-up study","description":"Computed tomography, limited or localized follow-up study","date_of_service":"2026-05-10","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":"23802","name":"Arthrd glenohumeral jt w/grf","description":"Arthrodesis, glenohumeral joint; with autogenous graft (includes obtaining graft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1335.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0642","name":"Lo sag ri an/pos pnl pre ots","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3540","name":"Ortho shoe add full sole","description":"Orthopedic shoe addition, sole, full","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58956","name":"Bso omentectomy w/tah","description":"Bilateral salpingo-oophorectomy with total omentectomy, total abdominal hysterectomy for malignancy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1598.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"J9293","name":"Mitoxantrone hydrochl / 5 mg","description":"Injection, mitoxantrone hydrochloride, per 5 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":321.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q0165","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"31530","name":"Laryngoscopy w/fb removal","description":"Laryngoscopy, direct, operative, with foreign body removal;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1093.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50945","name":"Laparoscopy ureterolithotomy","description":"Laparoscopy, surgical; ureterolithotomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5783","name":"Add low ext mec limb vol lam","description":"Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35471","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33207","name":"Insert heart pm ventricular","description":"Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); ventricular","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72190","name":"X-ray exam of pelvis","description":"Radiologic examination, pelvis; complete, minimum of 3 views","date_of_service":"2026-05-10","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":"94240","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0840","name":"Tract frame attach headboard","description":"Traction frame, attached to headboard, cervical traction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["QB","RR","QF"]}],"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":"2026-05-10","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":"42310","name":"Drainage of salivary gland","description":"Drainage of abscess; submaxillary or sublingual, intraoral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99082","name":"Unusual physician travel","description":"Unusual travel (eg, transportation and escort of patient)","date_of_service":"2026-05-10","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":"89230","name":"Collect sweat for test","description":"Sweat collection by iontophoresis","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57288","name":"Repair bladder defect","description":"Sling operation for stress incontinence (eg, fascia or synthetic)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":881.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1820","name":"Ko elas w/ condyle pads & jo","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-10","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":"57558","name":"D&c of cervical stump","description":"Dilation and curettage of cervical stump","date_of_service":"2026-05-10","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":"64508","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4023","name":"Cast sup sht arm splnt ped p","description":"Cast supplies, short arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"65755","name":"Corneal transplant","description":"Keratoplasty (corneal transplant); penetrating (in pseudophakia)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27610","name":"Explore/treat ankle joint","description":"Arthrotomy, ankle, including exploration, drainage, or removal of foreign body","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33019","name":"Perq prcrd drg insj cath ct","description":"Pericardial drainage with insertion of indwelling catheter, percutaneous, including ct guidance","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4860","name":"Disposable catheter tips","description":"Disposable catheter tips for peritoneal dialysis, per 10","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"32120","name":"Re-exploration of chest","description":"Thoracotomy; for postoperative complications","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":694.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83912","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"41017","name":"Drainage of mouth lesion","description":"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; submandibular","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87280","name":"Respiratory syncytial ag if","description":"Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A6577","name":"Custom grad cm sleeve heavy","description":"Gradient  compression arm sleeve, custom, heavy weight, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"27301","name":"Drain thigh/knee lesion","description":"Incision and drainage, deep abscess, bursa, or hematoma, thigh or knee region","date_of_service":"2026-05-10","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":"82715","name":"Assay of fecal fat","description":"Fat differential, feces, quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":925.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33140","name":"Heart revascularize (tmr)","description":"Transmyocardial laser revascularization, by thoracotomy; (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95869","name":"Ndl emg thrc paraspinal musc","description":"Needle electromyography; thoracic paraspinal muscles (excluding t1 or t12)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"26553","name":"Single transfer toe-hand","description":"Transfer, toe-to-hand with microvascular anastomosis; other than great toe, single","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2772.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92546","name":"Sinusoidal rotational test","description":"Sinusoidal vertical axis rotational testing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"49580","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","date_of_service":"2026-05-10","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":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-05-10","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":"78121","name":"Red cell mass multiple","description":"Red cell volume determination (separate procedure); multiple samplings","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43194","name":"Esophagoscp rig trnso rem fb","description":"Esophagoscopy, rigid, transoral; with removal of foreign body(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49657","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1105.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"29840","name":"Wrist arthroscopy","description":"Arthroscopy, wrist, diagnostic, with or without synovial biopsy (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69715","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1059.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73564","name":"X-ray exam knee 4 or more","description":"Radiologic examination, knee; complete, 4 or more views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"88311","name":"Decalcify tissue","description":"Decalcification procedure (list separately in addition to code for surgical pathology examination)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5505","name":"Diab shoe w/metatarsal bar","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99435","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4385","name":"Ost skn barrier sld ext wear","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"73201","name":"Ct upper extremity w/dye","description":"Computed tomography, upper extremity; with contrast material(s)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1815","name":"Adjust ankle ext & flex dev","description":"Dynamic adjustable ankle extension and flexion device, includes soft interface material","date_of_service":"2026-05-10","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":"44143","name":"Partial removal of colon","description":"Colectomy, partial; with end colostomy and closure of distal segment (hartmann type procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62163","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"77086","name":"Vrt fracture assmt via dxa","description":"Vertebral fracture assessment via dual-energy x-ray absorptiometry (dxa)","date_of_service":"2026-05-10","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":"A4429","name":"Urine ost pouch w bltinconv","description":"Ostomy pouch, urinary, with barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KN"]}],"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":"2026-05-10","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":"L6960","name":"Shldr disartic switch contro","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"T4521","name":"Adult size brief/diaper sm","description":"Adult sized disposable incontinence product, brief/diaper, small, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8510","name":"Voice amplifier","description":"Voice amplifier","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"15786","name":"Abrasion lesion single","description":"Abrasion; single lesion (eg, keratosis, scar)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50200","name":"Renal biopsy perq","description":"Renal biopsy; percutaneous, by trocar or needle","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1224.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97116","name":"Gait training therapy","description":"Therapeutic procedure, 1 or more areas, each 15 minutes; gait training (includes stair climbing)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82962","name":"Glucose blood test","description":"Glucose, blood by glucose monitoring device(s) cleared by the fda specifically for home use","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86684","name":"Hemophilus influenza antibdy","description":"Antibody; haemophilus influenza","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"80197","name":"Assay of tacrolimus","description":"Tacrolimus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-10","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":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00700","name":"Anes px upr ant abd wall nos","description":"Anesthesia for procedures on upper anterior abdominal wall; not otherwise specified","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94656","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"28406","name":"Prq skel fix clcnl fx w/mnpj","description":"Percutaneous skeletal fixation of calcaneal fracture, with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":652.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1378.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35701","name":"Expl n/flwd surg neck art","description":"Exploration not followed by surgical repair, artery; neck (eg, carotid, subclavian)","date_of_service":"2026-05-10","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":"41830","name":"Removal of gum tissue","description":"Alveolectomy, including curettage of osteitis or sequestrectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"60605","name":"Remove carotid body lesion","description":"Excision of carotid body tumor; with excision of carotid artery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1566.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2774.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2147.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1513.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77077","name":"Joint survey single view","description":"Joint survey, single view, 2 or more joints (specify)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72275","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["26"]}],"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":"2026-05-10","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":"46751","name":"Repair of anal sphincter","description":"Sphincteroplasty, anal, for incontinence or prolapse; child","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-10","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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0630","name":"Lso r post pnl sj-t9 pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","date_of_service":"2026-05-10","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":"01920","name":"Anes cardiac catheterization","description":"Anesthesia for cardiac catheterization including coronary angiography and ventriculography (not to include swan-ganz catheter)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58822","name":"Drain ovary abscess percut","description":"Drainage of ovarian abscess; abdominal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":733.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":798.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57545","name":"Remove cervix/repair pelvis","description":"Excision of cervical stump, abdominal approach; with pelvic floor repair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":944.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"45915","name":"Remove rectal obstruction","description":"Removal of fecal impaction or foreign body (separate procedure) under anesthesia","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"27355","name":"Remove femur lesion","description":"Excision or curettage of bone cyst or benign tumor of femur;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"98925","name":"Osteopath manj 1-2 regions","description":"Osteopathic manipulative treatment (omt); 1-2 body regions involved","date_of_service":"2026-05-10","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":"L2492","name":"Knee lift loop drop lock rin","description":"Addition to knee joint, lift loop for drop lock ring","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82608","name":"B-12 binding capacity","description":"Cyanocobalamin (vitamin b-12); unsaturated binding capacity","date_of_service":"2026-05-10","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":"E0745","name":"Neuromuscular stim for shock","description":"Neuromuscular stimulator, electronic shock unit","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"G0297","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90710","name":"Mmrv vaccine sc","description":"Measles, mumps, rubella, and varicella vaccine (mmrv), live, for subcutaneous use","date_of_service":"2026-05-10","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":329.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"27870","name":"Fusion of ankle joint open","description":"Arthrodesis, ankle, open","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1221.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":523.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74485","name":"Dilation urtr/urt rs&i","description":"Dilation of ureter(s) or urethra, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0583","name":"Bivalirudin","description":"Injection, bivalirudin, 1 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7330","name":"Cultured chondrocytes implnt","description":"Autologous cultured chondrocytes, implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16284.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KC"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"29044","name":"Appl bdy cst sho to hip 1thi","description":"Application of body cast, shoulder to hips; including 1 thigh","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11954","name":"Subq njx fil matrl>10.0 cc","description":"Subcutaneous injection of filling material (eg, collagen); over 10.0 cc","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"21310","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78760","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":794.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","date_of_service":"2026-05-10","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":"33320","name":"Repair major blood vessel(s)","description":"Suture repair of aorta or great vessels; without shunt or cardiopulmonary bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1204.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","date_of_service":"2026-05-10","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":"64905","name":"Nerve pedicle transfer","description":"Nerve pedicle transfer; first stage","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":861.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"00542","name":"Anes thrcm px decortication","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); decortication","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":364.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50395","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73092","name":"X-ray exam of arm infant","description":"Radiologic examination; upper extremity, infant, minimum of 2 views","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"92961","name":"Cardioversion electric int","description":"Cardioversion, elective, electrical conversion of arrhythmia; internal (separate procedure)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77620","name":"Hyperthermia gen intrcv prb","description":"Hyperthermia generated by intracavitary probe(s)","date_of_service":"2026-05-10","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":"42660","name":"Dilation of salivary duct","description":"Dilation and catheterization of salivary duct, with or without injection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32095","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"45383","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43611","name":"Excision of stomach lesion","description":"Excision, local; malignant tumor of stomach","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2715","name":"Prism lens/es","description":"Prism, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"00796","name":"Anes iper upr abd lvr trnspl","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; liver transplant (recipient)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.06,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64726","name":"Dcmprn plantar digital nerve","description":"Decompression; plantar digital nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70371","name":"Speech evaluation complex","description":"Complex dynamic pharyngeal and speech evaluation by cine or video recording","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50845","name":"Appendico-vesicostomy","description":"Cutaneous appendico-vesicostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1368.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","date_of_service":"2026-05-10","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":"42505","name":"Repair salivary duct","description":"Plastic repair of salivary duct, sialodochoplasty; secondary or complicated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":542.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":"91034","name":"Gastroesophageal reflux test","description":"Esophagus, gastroesophageal reflux test; with nasal catheter ph electrode(s) placement, recording, analysis and interpretation","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2690.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4428","name":"Urine ost pouch w faucet/tap","description":"Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1810","name":"Adjust knee ext & flex dev","description":"Dynamic adjustable knee extension and flexion device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":"00212","name":"Anes icr px subdural taps","description":"Anesthesia for intracranial procedures; subdural taps","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"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":"2026-05-10","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":"72074","name":"X-ray exam thorac spine4/>vw","description":"Radiologic examination, spine; thoracic, minimum of 4 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76945","name":"Echo guide villus sampling","description":"Ultrasonic guidance for chorionic villus sampling, imaging supervision and interpretation","date_of_service":"2026-05-10","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":"E0840","name":"Tract frame attach headboard","description":"Traction frame, attached to headboard, cervical traction","date_of_service":"2026-05-10","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":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"21452","name":"Perq tx mndblr fx xtrnl fixj","description":"Percutaneous treatment of mandibular fracture, with external fixation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.12,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64613","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"97139","name":"Unlisted therapeutic px","description":"Unlisted therapeutic procedure (specify)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31717","name":"Bronchial brush biopsy","description":"Catheterization with bronchial brush biopsy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2830","name":"Soft interface above knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, above knee section","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92225","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"67835","name":"Revise eyelashes","description":"Correction of trichiasis; incision of lid margin, with free mucous membrane graft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76817","name":"Transvaginal us obstetric","description":"Ultrasound, pregnant uterus, real time with image documentation, transvaginal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"82552","name":"Assay of cpk in blood","description":"Creatine kinase (ck), (cpk); isoenzymes","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"40808","name":"Biopsy of mouth lesion","description":"Biopsy, vestibule of mouth","date_of_service":"2026-05-10","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":"92552","name":"Pure tone audiometry air","description":"Pure tone audiometry (threshold); air only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21198","name":"Reconstr lwr jaw segment","description":"Osteotomy, mandible, segmental;","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00500","name":"Anes all px on esophagus","description":"Anesthesia for all procedures on esophagus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.16,"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":"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":"2026-05-10","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":"38308","name":"Incision of lymph channels","description":"Lymphangiotomy or other operations on lymphatic channels","date_of_service":"2026-05-10","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":"78201","name":"Liver imaging static only","description":"Liver imaging; static only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4414","name":"Ost sknbar w/o conv<=4 sq in","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1702.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70545","name":"Mr angiography head w/dye","description":"Magnetic resonance angiography, head; with contrast material(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8610","name":"Ocular implant","description":"Ocular implant","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1140.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"31820","name":"Closure of windpipe lesion","description":"Surgical closure tracheostomy or fistula; without plastic repair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45355","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0367","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"70490","name":"Ct soft tissue neck w/o dye","description":"Computed tomography, soft tissue neck; without contrast material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1655.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"00172","name":"Anes ntroral px rpr clft pal","description":"Anesthesia for intraoral procedures, including biopsy; repair of cleft palate","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32520","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1617.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["26"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"22224","name":"Osteot dsc ant 1vrt sgm lmbr","description":"Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; lumbar","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0365","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":352.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-05-10","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":"L2070","name":"Hkafo torsion unilat rot str","description":"Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3976","name":"Sewhfo airplane w/o jnts cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95819","name":"Eeg awake and asleep","description":"Electroencephalogram (eeg); including recording awake and asleep","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"00880","name":"Anes maj lwr abd vessel nos","description":"Anesthesia for procedures on major lower abdominal vessels; not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.16,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":820.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4540","name":"Reusable underpad chair size","description":"Incontinence product, protective underpad, reusable, chair size, each","date_of_service":"2026-05-10","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":"J1500","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4345.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1012.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88182","name":"Cell marker study","description":"Flow cytometry, cell cycle or dna analysis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46706","name":"Repr of anal fistula w/glue","description":"Repair of anal fistula with fibrin glue","date_of_service":"2026-05-10","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":"26485","name":"Transplant palm tendon","description":"Transfer or transplant of tendon, palmar; without free tendon graft, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1122.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2077.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33011","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":761.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11041","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J2278","name":"Ziconotide injection","description":"Injection, ziconotide, 1 microgram","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2060","name":"Hkafo torsion ball bearing j","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33845","name":"Excision coa w/graft","description":"Excision of coarctation of aorta, with or without associated patent ductus arteriosus; with graft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1647.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4021","name":"Cast sup sht arm splint plst","description":"Cast supplies, short arm splint, adult (11 years +), plaster","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93701","name":"Bioimpedance cv analysis","description":"Bioimpedance-derived physiologic cardiovascular analysis","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"99251","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00840","name":"Anes iper px lower abd nos","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"64430","name":"Njx aa&/strd pudendal nerve","description":"Injection(s), anesthetic agent(s) and/or steroid; pudendal nerve","date_of_service":"2026-05-10","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":"92590","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"41010","name":"Incision of tongue fold","description":"Incision of lingual frenum (frenotomy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"58600","name":"Division of fallopian tube","description":"Ligation or transection of fallopian tube(s), abdominal or vaginal approach, unilateral or bilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":428.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"30920","name":"Ligation upper jaw artery","description":"Ligation arteries; internal maxillary artery, transantral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1235.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6100","name":"Elb mold sock flex hinge pad","description":"Below elbow, molded socket, flexible elbow hinge, triceps pad","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83036","name":"Hemoglobin glycosylated a1c","description":"Hemoglobin; glycosylated (a1c)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70130","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; complete, minimum of 3 views per side","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","date_of_service":"2026-05-10","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":"33420","name":"Revision of mitral valve","description":"Valvotomy, mitral valve; closed heart","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58822","name":"Drain ovary abscess percut","description":"Drainage of ovarian abscess; abdominal approach","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"92993","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"53460","name":"Revision of urethra","description":"Urethromeatoplasty, with partial excision of distal urethral segment (richardson type procedure)","date_of_service":"2026-05-10","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":"26236","name":"Partial removal finger bone","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis); distal phalanx of finger","date_of_service":"2026-05-10","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":"45335","name":"Sigmoidoscopy w/submuc inj","description":"Sigmoidoscopy, flexible; with directed submucosal injection(s), any substance","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["26"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26844","name":"Fusion/graft of hand joint","description":"Arthrodesis, carpometacarpal joint, digit, other than thumb, each; with autograft (includes obtaining graft)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35261","name":"Rpr blvsl grf oth/thn vn nck","description":"Repair blood vessel with graft other than vein; neck","date_of_service":"2026-05-10","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":"00632","name":"Anes px lumbar sympathectomy","description":"Anesthesia for procedures in lumbar region; lumbar sympathectomy","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30100","name":"Intranasal biopsy","description":"Biopsy, intranasal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E1221","name":"Wheelchair spec size w foot","description":"Wheelchair with fixed arm, footrests","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"0154A","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0393","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1023.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4520","name":"Incontinence garment anytype","description":"Incontinence garment, any type, (e.g., brief, diaper), each","date_of_service":"2026-05-10","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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1509.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-10","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":"42500","name":"Repair salivary duct","description":"Plastic repair of salivary duct, sialodochoplasty; primary or simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"50725","name":"Release/revise ureter","description":"Ureterolysis for retrocaval ureter, with reanastomosis of upper urinary tract or vena cava","date_of_service":"2026-05-10","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":"72291","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","date_of_service":"2026-05-10","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":"62328","name":"Dx lmbr spi pnxr w/fluor/ct","description":"Spinal puncture, lumbar, diagnostic; with fluoroscopic or ct guidance","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90658","name":"Iiv3 vaccine splt 0.5 ml im","description":"Influenza virus vaccine, trivalent (iiv3), split virus, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","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":22.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83872","name":"Assay synovial fluid mucin","description":"Mucin, synovial fluid (ropes test)","date_of_service":"2026-05-10","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":"19103","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"87551","name":"Mycobacteria dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria species, amplified probe technique","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J2320","name":"Nandrolone decanoate 50 mg","description":"Injection, nandrolone decanoate, up to 50 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2300","name":"Lens sphere trifocal 4.00d","description":"Sphere, trifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-10","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":"78465","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3730","name":"Forearm/arm cuffs ext/flex a","description":"Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21453","name":"Cltx mndblr fx ntrdntl fixj","description":"Closed treatment of mandibular fracture with interdental fixation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":786.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"01732","name":"Anes dx arthrs px elbow jt","description":"Anesthesia for diagnostic arthroscopic procedures of elbow joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"59820","name":"Care of miscarriage","description":"Treatment of missed abortion, completed surgically; first trimester","date_of_service":"2026-05-10","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":"82331","name":"Calcium infusion test","description":"Calcium; after calcium infusion test","date_of_service":"2026-05-10","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":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L8659","name":"Interphalangeal joint repl","description":"Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size","date_of_service":"2026-05-10","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":"37221","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","date_of_service":"2026-05-10","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":"38555","name":"Removal neck/armpit lesion","description":"Excision of cystic hygroma, axillary or cervical; with deep neurovascular dissection","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90817","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"28160","name":"Partial removal of toe","description":"Hemiphalangectomy or interphalangeal joint excision, toe, proximal end of phalanx, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83719","name":"Assay of blood lipoprotein","description":"Lipoprotein, direct measurement; vldl cholesterol","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"42225","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate; attachment pharyngeal flap","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":776.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":352.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5513","name":"Multi den insert custom mold","description":"For diabetics only, multiple density insert, custom molded from model of patients foot, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":"J1470","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"G0455","name":"Fecal microbiota prep instil","description":"Preparation with instillation of fecal microbiota by any method, including assessment of donor specimen","date_of_service":"2026-05-10","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":"35526","name":"Art byp grft aor/carot/innom","description":"Bypass graft, with vein; aortosubclavian, aortoinnominate, or aortocarotid","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33820","name":"Repair pda by ligation","description":"Repair of patent ductus arteriosus; by ligation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1215.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86490","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"92553","name":"Audiometry air & bone","description":"Pure tone audiometry (threshold); air and bone","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"24605","name":"Tx clsd elbow dislc req anes","description":"Treatment of closed elbow dislocation; requiring anesthesia","date_of_service":"2026-05-10","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":"75827","name":"Vein x-ray chest","description":"Venography, caval, superior, with serialography, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"E0606","name":"Drainage board postural","description":"Postural drainage board","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77763","name":"Apply intrcav radiat compl","description":"Intracavitary radiation source application; complex","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"58120","name":"Dilation and curettage","description":"Dilation and curettage, diagnostic and/or therapeutic (nonobstetrical)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"86593","name":"Syphilis test non-trep quant","description":"Syphilis test, non-treponemal antibody; quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1119.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"87001","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"87177","name":"Ova and parasites smears","description":"Ova and parasites, direct smears, concentration and identification","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.16,"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":"78140","name":"Red cell sequestration","description":"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71015","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"43215","name":"Esophagoscopy flex remove fb","description":"Esophagoscopy, flexible, transoral; with removal of foreign body(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2530","name":"Contact lens gas impermeable","description":"Contact lens, scleral, gas impermeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"ATP16","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"15738","name":"Muscle-skin graft leg","description":"Muscle, myocutaneous, or fasciocutaneous flap; lower extremity","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":838.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0495","name":"Charger elec/combo vad, rep","description":"Battery/power pack charger for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2034.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11720","name":"Debride nail 1-5","description":"Debridement of nail(s) by any method(s); 1 to 5","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"81289","name":"Fxn gene known famil variant","description":"Fxn (frataxin) (eg, friedreich ataxia) gene analysis; known familial variant(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"23065","name":"Biopsy shoulder tissues","description":"Biopsy, soft tissue of shoulder area; superficial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2114","name":"Afo tib fx semi-rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-10","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":"23625","name":"Cltx gr hmrl tbrs fx w/mnpj","description":"Closed treatment of greater humeral tuberosity fracture; with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"88366","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["26"]}],"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":"2026-05-10","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":"31390","name":"Removal of larynx & pharynx","description":"Pharyngolaryngectomy, with radical neck dissection; without reconstruction","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1170","name":"Whlchr ampu fxd arm leg rest","description":"Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8514","name":"Repl trach puncture dilator","description":"Tracheoesophageal puncture dilator, replacement only, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1990","name":"Chlordiazepoxide injection","description":"Injection, chlordiazepoxide hcl, up to 100 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3070","name":"Arch suprt att to sho longit","description":"Foot, arch support, non-removable attached to shoe, longitudinal, each","date_of_service":"2026-05-10","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":"51700","name":"Irrigation of bladder","description":"Bladder irrigation, simple, lavage and/or instillation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1852","name":"Ko double upright prefab ots","description":"Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43341","name":"Fuse esophagus & intestine","description":"Esophagojejunostomy (without total gastrectomy); thoracic approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1158.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"V2745","name":"Tint, any color/solid/grad","description":"Addition to lens; tint, any color, solid, gradient or equal, excludes photochromatic, any lens material, per lens","date_of_service":"2026-05-10","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":"66165","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"01963","name":"Anes cesarean hysterectomy","description":"Anesthesia for cesarean hysterectomy without any labor analgesia/anesthesia care","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J9160","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1205.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64704","name":"Revise hand/foot nerve","description":"Neuroplasty; nerve of hand or foot","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1327.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70450","name":"Ct head/brain w/o dye","description":"Computed tomography, head or brain; without contrast material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6237","name":"Hydrocolld drg <=16 in w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"0044A","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6566","name":"Grad com garment neck/head","description":"Gradient compression garment, neck/head, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00848","name":"Anes iper px pel exentration","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; pelvic exenteration","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-10","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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":839.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["BA","KG","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"62225","name":"Replace/irrigate catheter","description":"Replacement or irrigation, ventricular catheter","date_of_service":"2026-05-10","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":"82585","name":"Assay of cryofibrinogen","description":"Cryofibrinogen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29445","name":"Appl rigid tot cntc leg cast","description":"Application of rigid total contact leg cast","date_of_service":"2026-05-10","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":"L6590","name":"Shdr fair lead cable direct","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"66635","name":"Removal of iris","description":"Iridectomy, with corneoscleral or corneal section; optical (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"00524","name":"Anes clsd ch px pneumocents","description":"Anesthesia for closed chest procedures; pneumocentesis","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26442","name":"Release palm & finger tendon","description":"Tenolysis, flexor tendon; palm and finger, each tendon","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82040","name":"Assay of serum albumin","description":"Albumin; serum, plasma or whole blood","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27712","name":"Osteot mlt relignmt imed rod","description":"Osteotomy; multiple, with realignment on intramedullary rod (eg, sofield type procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1252.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"70544","name":"Mr angiography head w/o dye","description":"Magnetic resonance angiography, head; without contrast material(s)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00142","name":"Anes px on eye lens surgery","description":"Anesthesia for procedures on eye; lens surgery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"24931","name":"Amputate upper arm & implant","description":"Amputation, arm through humerus; with implant","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"B9004","name":"Parenteral infus pump portab","description":"Parenteral nutrition infusion pump, portable","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83887","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"67400","name":"Explore/biopsy eye socket","description":"Orbitotomy without bone flap (frontal or transconjunctival approach); for exploration, with or without biopsy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1050","name":"Whelchr fxd full length arms","description":"Fully-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94260","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0496","name":"Battery elec/combo vad, rep","description":"Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"67938","name":"Remove eyelid foreign body","description":"Removal of embedded foreign body, eyelid","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"83912","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3912","name":"Hfo flexion glove pre ots","description":"Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","date_of_service":"2026-05-10","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":"J0128","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"83012","name":"Assay of haptoglobins","description":"Haptoglobin; phenotypes","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"85337","name":"Thrombomodulin","description":"Thrombomodulin","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4606","name":"Oxygen probe used w oximeter","description":"Oxygen probe for use with oximeter device, replacement","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"46040","name":"I&d ischiorct&/perirct absc","description":"Incision and drainage of ischiorectal and/or perirectal abscess (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74150","name":"Ct abdomen w/o contrast","description":"Computed tomography, abdomen; without contrast material","date_of_service":"2026-05-10","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":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"26567","name":"Correct finger deformity","description":"Osteotomy; phalanx of finger, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0452","name":"Molecular pathology interpr","description":"Molecular pathology procedure; physician interpretation and report","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25492","name":"Prophylactic tx radius&ulna","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; radius and ulna","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":765.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28062","name":"Removal of foot fascia","description":"Fasciectomy, plantar fascia; radical (separate procedure)","date_of_service":"2026-05-10","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":"93740","name":"Temperature gradient studies","description":"Temperature gradient studies","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"ATP04","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33011","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0870","name":"Tract frame attach footboard","description":"Traction frame, attached to footboard, extremity traction, (e.g., bucks)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26852","name":"Fusion of knuckle with graft","description":"Arthrodesis, metacarpophalangeal joint, with or without internal fixation; with autograft (includes obtaining graft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":670.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64761","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"ATP08","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27025","name":"Fasciotomy hip/thigh any typ","description":"Fasciotomy, hip or thigh, any type","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"J7616","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"90735","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":"63197","name":"Lam w/cordotomy 1stg thrc","description":"Laminectomy with cordotomy, with section of both spinothalamic tracts, 1 stage, thoracic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1792.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22850","name":"Remove spine fixation device","description":"Removal of posterior nonsegmental instrumentation (eg, harrington rod)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"37609","name":"Ligation/bx temporal artery","description":"Ligation or biopsy, temporal artery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"72120","name":"X-ray bend only l-s spine","description":"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"23465","name":"Repair shoulder capsule","description":"Capsulorrhaphy, glenohumeral joint, posterior, with or without bone block","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2299.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28340","name":"Resect enlarged toe tissue","description":"Reconstruction, toe, macrodactyly; soft tissue resection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":540.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"M0064","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0548T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"ATP21","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88264","name":"Chromosome analysis 20-25","description":"Chromosome analysis; analyze 20-25 cells","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61557","name":"Incise skull/sutures","description":"Craniotomy for craniosynostosis; bifrontal bone flap","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1939.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-05-10","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":"E1802","name":"Adjst forearm pro/sup device","description":"Dynamic adjustable forearm pronation/supination device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L0640","name":"Lso s/c shell/panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1301.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64771","name":"Sever cranial nerve","description":"Transection or avulsion of other cranial nerve, extradural","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"85611","name":"Prothrombin test","description":"Prothrombin time; substitution, plasma fractions, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"69605","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1847.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"73010","name":"X-ray exam of shoulder blade","description":"Radiologic examination; scapula, complete","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"36450","name":"Bld exchange truj newborn","description":"Exchange transfusion, blood; newborn","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"92609","name":"Use of speech device service","description":"Therapeutic services for the use of speech-generating device, including programming and modification","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"61610","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5514","name":"Mult den insert dir carv/cam","description":"For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes ar","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62302","name":"Myelography lumbar injection","description":"Myelography via lumbar injection, including radiological supervision and interpretation; cervical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"75557","name":"Cardiac mri for morph","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1513.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":627.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42700","name":"I&d abscess peritonsillar","description":"Incision and drainage abscess; peritonsillar","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"70015","name":"Contrast x-ray of brain","description":"Cisternography, positive contrast, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"98943","name":"Chiropract manj xtrspinl 1/>","description":"Chiropractic manipulative treatment (cmt); extraspinal, 1 or more regions","date_of_service":"2026-05-10","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":"71022","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":928.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"83918","name":"Organic acids total quant","description":"Organic acids; total, quantitative, each specimen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43425","name":"Repair esophagus opening","description":"Closure of esophagostomy or fistula; transthoracic or transabdominal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00868","name":"Anes xtrprtl px rnl transpl","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; renal transplant (recipient)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"25250","name":"Removal of wrist prosthesis","description":"Removal of wrist prosthesis; (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42955","name":"Surgical opening of throat","description":"Pharyngostomy (fistulization of pharynx, external for feeding)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":588.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71021","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47553","name":"Biliary endoscopy thru skin","description":"Biliary endoscopy, percutaneous via t-tube or other tract; with biopsy, single or multiple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","date_of_service":"2026-05-10","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":"75894","name":"X-rays transcath therapy","description":"Transcatheter therapy, embolization, any method, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"51725","name":"Simple cystometrogram","description":"Simple cystometrogram (cmg) (eg, spinal manometer)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26785","name":"Treat finger dislocation","description":"Open treatment of interphalangeal joint dislocation, includes internal fixation, when performed, single","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5622","name":"Test socket knee disarticula","description":"Addition to lower extremity, test socket, knee disarticulation","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5105","name":"Plast socket jts/thgh lacer","description":"Below knee, plastic socket, joints and thigh lacer, sach foot","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77777","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1632.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87270","name":"Chlamydia trachomatis ag if","description":"Infectious agent antigen detection by immunofluorescent technique; chlamydia trachomatis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43887","name":"Gstr rstcv px opn rmvl port","description":"Gastric restrictive procedure, open; removal of subcutaneous port component only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1852.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1397.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0291","name":"Hosp bed fx ht w/o rail w/o","description":"Hospital bed, fixed height, without side rails, without mattress","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.16,"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":"10021","name":"Fna bx w/o img gdn 1st les","description":"Fine needle aspiration biopsy, without imaging guidance; first lesion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0489","name":"Pwr pck base combo vad, rep","description":"Power pack base for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"73115","name":"Contrast x-ray of wrist","description":"Radiologic examination, wrist, arthrography, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6209","name":"Foam drsg <=16 sq in w/o bdr","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"33690","name":"Banding pulmonary artery","description":"Banding of pulmonary artery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1402.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"78605","name":"Brain image 4+ views","description":"Brain imaging, minimum 4 static views;","date_of_service":"2026-05-10","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":"28576","name":"Treat foot dislocation","description":"Percutaneous skeletal fixation of talotarsal joint dislocation, with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78601","name":"Brain image w/flow < 4 views","description":"Brain imaging, less than 4 static views; with vascular flow","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"72275","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0941","name":"Gravity assisted traction de","description":"Gravity assisted traction device, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":377.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77073","name":"Bone length studies","description":"Bone length studies (orthoroentgenogram, scanogram)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"21740","name":"Reconstruction of sternum","description":"Reconstructive repair of pectus excavatum or carinatum; open","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":891.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5782","name":"Hd low limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":955.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73030","name":"X-ray exam of shoulder","description":"Radiologic examination, shoulder; complete, minimum of 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92287","name":"Ant sgm img ir flrscn angrph","description":"Anterior segment imaging with interpretation and report; with fluorescein angiography","date_of_service":"2026-05-10","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":"97004","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82951","name":"Glucose tolerance test (gtt)","description":"Glucose; tolerance test (gtt), 3 specimens (includes glucose)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"83840","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"25365","name":"Revise radius & ulna","description":"Osteotomy; radius and ulna","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87084","name":"Culture of specimen by kit","description":"Culture, presumptive, pathogenic organisms, screening only; with colony estimation from density chart","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"G0504","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0282","name":"Amiodarone hcl","description":"Injection, amiodarone hydrochloride, 30 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4045","name":"Replace non-molded thigh lac","description":"Replace non-molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-10","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":"A6154","name":"Wound pouch each","description":"Wound pouch, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"91020","name":"Gastric motility studies","description":"Gastric motility (manometric) studies","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83945","name":"Assay of oxalate","description":"Oxalate","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83872","name":"Assay synovial fluid mucin","description":"Mucin, synovial fluid (ropes test)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"48154","name":"Pancreatectomy","description":"Pancreatectomy, proximal subtotal with near-total duodenectomy, choledochoenterostomy and duodenojejunostomy (pylorus-sparing, whipple-type procedure); without pancreatojejunostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3032.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0880","name":"Trac stand free stand extrem","description":"Traction stand, free standing, extremity traction","date_of_service":"2026-05-10","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":"83499","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52330","name":"Cystoscopy and treatment","description":"Cystourethroscopy (including ureteral catheterization); with manipulation, without removal of ureteral calculus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2720","name":"Inj protamine sulfate/10 mg","description":"Injection, protamine sulfate, per 10 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80202","name":"Assay of vancomycin","description":"Vancomycin","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":735.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3671","name":"So cap design w/o jnts cf","description":"Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69603","name":"Revj mstdc rsltg rad mstdc","description":"Revision mastoidectomy; resulting in radical mastoidectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1521.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"82384","name":"Assay three catecholamines","description":"Catecholamines; fractionated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"29901","name":"Mcp joint arthroscopy surg","description":"Arthroscopy, metacarpophalangeal joint, surgical; with debridement","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45331","name":"Sigmoidoscopy and biopsy","description":"Sigmoidoscopy, flexible; with biopsy, single or multiple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00162","name":"Anes px nose&sinus rad surg","description":"Anesthesia for procedures on nose and accessory sinuses; radical surgery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1860.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63620","name":"Srs spinal lesion","description":"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 spinal lesion","date_of_service":"2026-05-10","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":"00830","name":"Anes hernia rpr lwr abd nos","description":"Anesthesia for hernia repairs in lower abdomen; not otherwise specified","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-10","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":"26460","name":"Incise hand/finger tendon","description":"Tenotomy, extensor, hand or finger, open, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":517.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0172","name":"Cerv col sr foam 2pc pre ots","description":"Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"82948","name":"Reagent strip/blood glucose","description":"Glucose; blood, reagent strip","date_of_service":"2026-05-10","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":"L3209","name":"Surgical boot each child","description":"Surgical boot, each, child","date_of_service":"2026-05-10","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":"85652","name":"Rbc sed rate automated","description":"Sedimentation rate, erythrocyte; automated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24576","name":"Cltx humrl cndylr fx wo mnpj","description":"Closed treatment of humeral condylar fracture, medial or lateral; without manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5686","name":"Bk back check","description":"Addition to lower extremity, below knee, back check (extension control)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"58752","name":"Revise ovarian tube(s)","description":"Tubouterine implantation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26499","name":"Correction claw finger other","description":"Correction claw finger, other methods","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1076.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6698","name":"Add up-ex prosthes lock mech","description":"Addition to upper extremity prosthesis, lock mechanism, excludes socket insert","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15121","name":"Splt agrft f/s/n/h/f/g/m ea","description":"Split-thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50770","name":"Splicing of ureters","description":"Transureteroureterostomy, anastomosis of ureter to contralateral ureter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1265.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":943.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"53415","name":"Reconstruction of urethra","description":"Urethroplasty, transpubic or perineal, 1-stage, for reconstruction or repair of prostatic or membranous urethra","date_of_service":"2026-05-10","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":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3975","name":"Sewhfo cap design w/o jnt cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":"29583","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":539.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26645","name":"Treat thumb fracture","description":"Closed treatment of carpometacarpal fracture dislocation, thumb (bennett fracture), with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73600","name":"X-ray exam of ankle","description":"Radiologic examination, ankle; 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69550","name":"Exc aurl glomus tum trnscanl","description":"Excision aural glomus tumor; transcanal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1214.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3977","name":"Sewhfo cap desgn w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"90783","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"85730","name":"Thromboplastin time partial","description":"Thromboplastin time, partial (ptt); plasma or whole blood","date_of_service":"2026-05-10","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":"L5710","name":"Kne-shin exo sng axi mnl loc","description":"Addition, exoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61542","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"L8509","name":"Trach-esoph voice pros md in","description":"Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type","date_of_service":"2026-05-10","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":"79101","name":"Nuclear rx iv admin","description":"Radiopharmaceutical therapy, by intravenous administration","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"G0008","name":"Admin influenza virus vac","description":"Administration of influenza virus vaccine","date_of_service":"2026-05-10","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":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":"26770","name":"Treat finger dislocation","description":"Closed treatment of interphalangeal joint dislocation, single, with manipulation; without anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"10140","name":"I&d hmtma seroma/fluid collj","description":"Incision and drainage of hematoma, seroma or fluid collection","date_of_service":"2026-05-10","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":"47550","name":"Bile duct endoscopy add-on","description":"Biliary endoscopy, intraoperative (choledochoscopy) (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93531","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2181.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00542","name":"Anes thrcm px decortication","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); decortication","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.16,"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27138","name":"Revise hip joint replacement","description":"Revision of total hip arthroplasty; femoral component only, with or without allograft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26531","name":"Revise knuckle with implant","description":"Arthroplasty, metacarpophalangeal joint; with prosthetic implant, each joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":523.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"38792","name":"Ra tracer id of sentinl node","description":"Injection procedure; radioactive tracer for identification of sentinel node","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76641","name":"Ultrasound breast complete","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete","date_of_service":"2026-05-10","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":"77786","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0499","name":"Belt/vest elec/combo vad rep","description":"Belt/vest/bag for use to carry external peripheral components of any type ventricular assist device, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"70030","name":"X-ray eye for foreign body","description":"Radiologic examination, eye, for detection of foreign body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66030","name":"Injection treatment of eye","description":"Injection, anterior chamber of eye (separate procedure); medication","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5250","name":"Hip canad sing axi cons fric","description":"Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78700","name":"Kidney imaging morphol","description":"Kidney imaging morphology;","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1366.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27720","name":"Repair of tibia","description":"Repair of nonunion or malunion, tibia; without graft, (eg, compression technique)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1059.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"25620","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":786.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66983","name":"Cataract surg w/iol 1 stage","description":"Intracapsular cataract extraction with insertion of intraocular lens prosthesis (1 stage procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"76932","name":"Echo guide for heart biopsy","description":"Ultrasonic guidance for endomyocardial biopsy, imaging supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87230","name":"Toxin/antitoxin asy tiss cul","description":"Toxin or antitoxin assay, tissue culture (eg, clostridium difficile toxin)","date_of_service":"2026-05-10","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":"11000","name":"Dbrdmt ecz/infected skin<10%","description":"Debridement of extensive eczematous or infected skin; up to 10% of body surface","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96103","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"87076","name":"Culture anaerobe ident each","description":"Culture, bacterial; anaerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-05-10","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":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5655","name":"Socket insert below knee","description":"Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"72295","name":"X-ray of lower spine disk","description":"Discography, lumbar, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"57305","name":"Repair rectum-vagina fistula","description":"Closure of rectovaginal fistula; abdominal approach","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":672.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0986","name":"Man w/c powr assist syst","description":"Manual wheelchair accessory, power assist system","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5697","name":"Ak/knee disartic pelvic band","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic band","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"50785","name":"Reimplant ureter in bladder","description":"Ureteroneocystostomy; with vesico-psoas hitch or bladder flap","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59030","name":"Fetal scalp blood sampling","description":"Fetal scalp blood sampling","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"42000","name":"Drainage mouth roof lesion","description":"Drainage of abscess of palate, uvula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"35558","name":"Art byp grft fem-femoral","description":"Bypass graft, with vein; femoral-femoral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1505.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":842.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2650","name":"Prednisolone acetate inj","description":"Injection, prednisolone acetate, up to 1 ml","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1604.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49426","name":"Revise abdomen-venous shunt","description":"Revision of peritoneal-venous shunt","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49402","name":"Remove foreign body adbomen","description":"Removal of peritoneal foreign body from peritoneal cavity","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78761","name":"Testicular imaging w/flow","description":"Testicular imaging with vascular flow","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82654","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-10","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":"74480","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"67027","name":"Implant eye drug system","description":"Implantation of intravitreal drug delivery system (eg, ganciclovir implant), includes concomitant removal of vitreous","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9217","name":"Leuprolide acetate suspnsion","description":"Leuprolide acetate (for depot suspension), 7.5 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73620","name":"X-ray exam of foot","description":"Radiologic examination, foot; 2 views","date_of_service":"2026-05-10","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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00928","name":"Anes male gent rad orch abd","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); radical orchiectomy, abdominal","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"77427","name":"Radiation tx management x5","description":"Radiation treatment management, 5 treatments","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93590","name":"Perq transcath cls mitral","description":"Percutaneous transcatheter closure of paravalvular leak; initial occlusion device, mitral valve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1043.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86148","name":"Anti-phospholipid antibody","description":"Anti-phosphatidylserine (phospholipid) antibody","date_of_service":"2026-05-10","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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69662","name":"Revise middle ear bone","description":"Revision of stapedectomy or stapedotomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":655.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":527.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01215","name":"Anes opn revj tot hip arthrp","description":"Anesthesia for open procedures involving hip joint; revision of total hip arthroplasty","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-10","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":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39520","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92070","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"82930","name":"Gastric analy w/ph ea spec","description":"Gastric acid analysis, includes ph if performed, each specimen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","date_of_service":"2026-05-10","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":"74455","name":"X-ray urethra/bladder","description":"Urethrocystography, voiding, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23333","name":"Remove shoulder fb deep","description":"Removal of foreign body, shoulder; deep (subfascial or intramuscular)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":498.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"15920","name":"Exc coccygl pr ulc prim sutr","description":"Excision, coccygeal pressure ulcer, with coccygectomy; with primary suture","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":607.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"43800","name":"Pyloroplasty","description":"Pyloroplasty","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":780.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91112","name":"Gi wireless capsule measure","description":"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","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":"90810","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"87551","name":"Mycobacteria dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria species, amplified probe technique","date_of_service":"2026-05-10","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":"00800","name":"Anes px lwr ant abdl wal nos","description":"Anesthesia for procedures on lower anterior abdominal wall; not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50780","name":"Reimplant ureter in bladder","description":"Ureteroneocystostomy; anastomosis of single ureter to bladder","date_of_service":"2026-05-10","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":"35570","name":"Art byp tibial-tib/peroneal","description":"Bypass graft, with vein; tibial-tibial, peroneal-tibial, or tibial/peroneal trunk-tibial","date_of_service":"2026-05-10","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":"35563","name":"Art byp grft ilioiliac","description":"Bypass graft, with vein; ilioiliac","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"82735","name":"Assay of fluoride","description":"Fluoride","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"33403","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00174","name":"Anes ntrorl exc rtrphrng tum","description":"Anesthesia for intraoral procedures, including biopsy; excision of retropharyngeal tumor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A4407","name":"Ext wear ost skn barr <=4sqin","description":"Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q0486","name":"Mon cable elec/pneum vad rep","description":"Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"A6456","name":"Zinc paste band w >=3in<5in/yd","description":"Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1221","name":"Wheelchair spec size w foot","description":"Wheelchair with fixed arm, footrests","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","date_of_service":"2026-05-10","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":"70373","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73510","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82928","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"Q0035","name":"Cardiokymography","description":"Cardiokymography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"32140","name":"Removal of lung lesion(s)","description":"Thoracotomy; with cyst(s) removal, includes pleural procedure when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"L3207","name":"Hightop w/ supp/pronator jun","description":"Orthopedic shoe, hightop with supinator or pronator, junior","date_of_service":"2026-05-10","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":"22600","name":"Arthrd pst tq 1ntrspc crv","description":"Arthrodesis, posterior or posterolateral technique, single interspace; cervical below c2 segment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1147.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21230","name":"Rib cartilage graft","description":"Graft; rib cartilage, autogenous, to face, chin, nose or ear (includes obtaining graft)","date_of_service":"2026-05-10","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":"76856","name":"Us exam pelvic complete","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54120","name":"Partial removal of penis","description":"Amputation of penis; partial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24366","name":"Reconstruct head of radius","description":"Arthroplasty, radial head; with implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78232","name":"Salivary gland function std","description":"Salivary gland function study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2210","name":"Lens sphcy bifocal 4.25-7/ov","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"53660","name":"Dilation of urethra","description":"Dilation of female urethra including suppository and/or instillation; initial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"56605","name":"Biopsy of vulva/perineum","description":"Biopsy of vulva or perineum (separate procedure); 1 lesion","date_of_service":"2026-05-10","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":"46045","name":"I&d absc tranal under anes","description":"Incision and drainage of intramural, intramuscular, or submucosal abscess, transanal, under anesthesia","date_of_service":"2026-05-10","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":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"93237","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2076.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58770","name":"Create new tubal opening","description":"Salpingostomy (salpingoneostomy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1911.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0297","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"46947","name":"Hemorrhoidopexy by stapling","description":"Hemorrhoidopexy (eg, for prolapsing internal hemorrhoids) by stapling","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61545","name":"Excision of brain tumor","description":"Craniotomy with elevation of bone flap; for excision of craniopharyngioma","date_of_service":"2026-05-10","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":"29130","name":"Appl finger splint static","description":"Application of finger splint; static","date_of_service":"2026-05-10","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":"31231","name":"Nasal endoscopy dx","description":"Nasal endoscopy, diagnostic, unilateral or bilateral (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"21440","name":"Cltx mndblr/max alv ridge fx","description":"Closed treatment of mandibular or maxillary alveolar ridge fracture (separate procedure)","date_of_service":"2026-05-10","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":"23473","name":"Revis reconst shoulder joint","description":"Revision of total shoulder arthroplasty, including allograft when performed; humeral or glenoid component","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1993.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"28226","name":"Release of foot tendons","description":"Tenolysis, extensor, foot; multiple tendons","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":400.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6930","name":"Below elbow switch control","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84482","name":"T3 reverse","description":"Triiodothyronine t3; reverse","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00162","name":"Anes px nose&sinus rad surg","description":"Anesthesia for procedures on nose and accessory sinuses; radical surgery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"58323","name":"Sperm washing","description":"Sperm washing for artificial insemination","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88355","name":"M/phmtrc alys skeletal musc","description":"Morphometric analysis; skeletal muscle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30903","name":"Control of nosebleed","description":"Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) any method","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2630","name":"Pelvic control band & belt u","description":"Addition to lower extremity, pelvic control, band and belt, unilateral","date_of_service":"2026-05-10","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":"00906","name":"Anes vulvectomy","description":"Anesthesia for; vulvectomy","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0484","name":"Tlso rigid plastic cust fab","description":"Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by ov","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"55866","name":"Laps surg prst8ect rpbic rad","description":"Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1168.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0431","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3984","name":"Upper ext fx orthosis wrist","description":"Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78111","name":"Plasma volume multiple","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings","date_of_service":"2026-05-10","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":"50900","name":"Repair of ureter","description":"Ureterorrhaphy, suture of ureter (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25066","name":"Biopsy forearm soft tissues","description":"Biopsy, soft tissue of forearm and/or wrist; deep (subfascial or intramuscular)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45334","name":"Sigmoidoscopy for bleeding","description":"Sigmoidoscopy, flexible; with control of bleeding, any method","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76641","name":"Ultrasound breast complete","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"70190","name":"X-ray exam of eye sockets","description":"Radiologic examination; optic foramina","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":951.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"27202","name":"Treat tail bone fracture","description":"Open treatment of coccygeal fracture","date_of_service":"2026-05-10","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":"51785","name":"Anal/urinary muscle study","description":"Needle electromyography studies (emg) of anal or urethral sphincter, any technique","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52341","name":"Cysto w/ureter stricture tx","description":"Cystourethroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2820.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"44208","name":"L colectomy/coloproctostomy","description":"Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis) with colostomy","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27613","name":"Biopsy lower leg soft tissue","description":"Biopsy, soft tissue of leg or ankle area; superficial","date_of_service":"2026-05-10","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":"01212","name":"Anes open px hip jt disrtcj","description":"Anesthesia for open procedures involving hip joint; hip disarticulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80176","name":"Assay of lidocaine","description":"Lidocaine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"83499","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"40520","name":"Partial excision of lip","description":"Excision of lip; v-excision with primary direct linear closure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":419.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76076","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35761","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1313.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"74150","name":"Ct abdomen w/o contrast","description":"Computed tomography, abdomen; without contrast material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3208","name":"Surgical boot each infant","description":"Surgical boot, each, infant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33720","name":"Repair of heart defect","description":"Repair sinus of valsalva aneurysm, with cardiopulmonary bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1908.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"43420","name":"Repair esophagus opening","description":"Closure of esophagostomy or fistula; cervical approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":788.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89235","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"00832","name":"Anes hernia repair vnt&incal","description":"Anesthesia for hernia repairs in lower abdomen; ventral and incisional hernias","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95056","name":"Photo tests","description":"Photo tests","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74020","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"87652","name":"Strep a dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); streptococcus, group a, quantification","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":933.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69915","name":"Incise inner ear nerve","description":"Vestibular nerve section, translabyrinthine approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1228.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32480","name":"Partial removal of lung","description":"Removal of lung, other than pneumonectomy; single lobe (lobectomy)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["26"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31294","name":"Nsl/sins ndsc surg on dcmprn","description":"Nasal/sinus endoscopy, surgical, with optic nerve decompression","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","date_of_service":"2026-05-10","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":"31380","name":"Partial removal of larynx","description":"Partial laryngectomy (hemilaryngectomy); anterovertical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1444.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51785","name":"Anal/urinary muscle study","description":"Needle electromyography studies (emg) of anal or urethral sphincter, any technique","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52275","name":"Cystoscopy & revise urethra","description":"Cystourethroscopy, with internal urethrotomy; male","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":425.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29844","name":"Wrist arthroscopy/surgery","description":"Arthroscopy, wrist, surgical; synovectomy, partial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"57106","name":"Vagnc prtl rmvl vag wall","description":"Vaginectomy, partial removal of vaginal wall;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80173","name":"Assay of haloperidol","description":"Haloperidol","date_of_service":"2026-05-10","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":"64550","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"83060","name":"Hgb sulfhemoglobin quan","description":"Hemoglobin; sulfhemoglobin, quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76078","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"62142","name":"Rmvl b1 flp/prostc plate skl","description":"Removal of bone flap or prosthetic plate of skull","date_of_service":"2026-05-10","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":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"49540","name":"Repair lumbar hernia","description":"Repair lumbar hernia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73501","name":"X-ray exam hip uni 1 view","description":"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view","date_of_service":"2026-05-10","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":"88283","name":"Chromosome banding study","description":"Chromosome analysis; additional specialized banding technique (eg, nor, c-banding)","date_of_service":"2026-05-10","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":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","date_of_service":"2026-05-10","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":"00147","name":"Anes px on eye iridectomy","description":"Anesthesia for procedures on eye; iridectomy","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32100","name":"Exploration of chest","description":"Thoracotomy; with exploration","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1132.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":670.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5684","name":"Bk fork strap","description":"Addition to lower extremity, below knee, fork strap","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"67415","name":"Aspiration orbital contents","description":"Fine needle aspiration of orbital contents","date_of_service":"2026-05-10","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":"93555","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29898","name":"Ankle arthroscopy/surgery","description":"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, extensive","date_of_service":"2026-05-10","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":"75733","name":"Artery x-rays adrenals","description":"Angiography, adrenal, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"A4375","name":"Drainable plastic pch w fcpl","description":"Ostomy pouch, drainable, with faceplate attached, plastic, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"96405","name":"Chemo intralesional up to 7","description":"Chemotherapy administration; intralesional, up to and including 7 lesions","date_of_service":"2026-05-10","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":"24362","name":"Reconstruct elbow joint","description":"Arthroplasty, elbow; with implant and fascia lata ligament reconstruction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":897.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29305","name":"Appl hip spica cast 1 leg","description":"Application of hip spica cast; 1 leg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22851","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":529.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77789","name":"Apply surf ldr radionuclide","description":"Surface application of low dose rate radionuclide source","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31390","name":"Removal of larynx & pharynx","description":"Pharyngolaryngectomy, with radical neck dissection; without reconstruction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2432.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":720.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5859","name":"Knee-shin pro flex/ext cont","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2202","name":"Lens sphere bifocal 7.12-20.","description":"Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"34825","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":588.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26561","name":"Repair of web finger","description":"Repair of syndactyly (web finger) each web space; with skin flaps and grafts","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2755","name":"Carbon graphite lamination","description":"Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1435.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78630","name":"Cerebrospinal fluid scan","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KN"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44186","name":"Lap jejunostomy","description":"Laparoscopy, surgical; jejunostomy (eg, for decompression or feeding)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1306.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"28308","name":"Incision of metatarsal","description":"Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; other than first metatarsal, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92136","name":"Ophthalmic biometry","description":"Ophthalmic biometry by partial coherence interferometry with intraocular lens power calculation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"93882","name":"Extracranial uni/ltd study","description":"Duplex scan of extracranial arteries; unilateral or limited study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73200","name":"Ct upper extremity w/o dye","description":"Computed tomography, upper extremity; without contrast material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01770","name":"Anes px art upr arm&elbw nos","description":"Anesthesia for procedures on arteries of upper arm and elbow; not otherwise specified","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":364.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1685","name":"Post-op hip abduct custom fa","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1072.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1971","name":"Afo w/ankle joint, prefab","description":"Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2101","name":"Single visn sphere 4.12-7.00","description":"Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"26055","name":"Incise finger tendon sheath","description":"Tendon sheath incision (eg, for trigger finger)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0350","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8507","name":"Trach-esoph voice pros pt in","description":"Tracheo-esophageal voice prosthesis, patient inserted, any type, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1798.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31502","name":"Change of windpipe airway","description":"Tracheotomy tube change prior to establishment of fistula tract","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-10","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":"21116","name":"Injection jaw joint x-ray","description":"Injection procedure for temporomandibular joint arthrography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31002","name":"Irrigation sphenoid sinus","description":"Lavage by cannulation; sphenoid sinus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66500","name":"Incision of iris","description":"Iridotomy by stab incision (separate procedure); except transfixion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1372.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"30124","name":"Removal of nose lesion","description":"Excision dermoid cyst, nose; simple, skin, subcutaneous","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3047.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77031","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87274","name":"Herpes simplex 1 ag if","description":"Infectious agent antigen detection by immunofluorescent technique; herpes simplex virus type 1","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"29520","name":"Strapping of hip","description":"Strapping; hip","date_of_service":"2026-05-10","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":"42962","name":"Control throat bleeding","description":"Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); with secondary surgical intervention","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2770","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4352","name":"Coude tip urinary catheter","description":"Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1612.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1603.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67820","name":"Revise eyelashes","description":"Correction of trichiasis; epilation, by forceps only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3126.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27282","name":"Arthrodesis symphysis pubis","description":"Arthrodesis, symphysis pubis (including obtaining graft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":963.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E1825","name":"Adjust finger ext & flex dev","description":"Dynamic adjustable finger extension and flexion device, includes soft interface material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-10","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":"77411","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"67820","name":"Revise eyelashes","description":"Correction of trichiasis; epilation, by forceps only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"J1094","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"L2010","name":"Kafo sng solid stirrup w/o j","description":"Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), without knee joint, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L4397","name":"Static or dynami afo pre ots","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78130","name":"Red cell survival study","description":"Red cell survival study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32670","name":"Thoracoscopy bilobectomy","description":"Thoracoscopy, surgical; with removal of two lobes (bilobectomy)","date_of_service":"2026-05-10","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":"73615","name":"Contrast x-ray of ankle","description":"Radiologic examination, ankle, arthrography, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-10","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":"50760","name":"Ureteroureterostomy","description":"Ureteroureterostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1213.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71110","name":"X-ray exam ribs bil 3 views","description":"Radiologic examination, ribs, bilateral; 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00944","name":"Anes vag px vag hysterectomy","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); vaginal hysterectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"56515","name":"Destroy vulva lesion/s compl","description":"Destruction of lesion(s), vulva; extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1922.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97026","name":"Infrared therapy","description":"Application of a modality to 1 or more areas; infrared","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"32400","name":"Needle biopsy chest lining","description":"Biopsy, pleura, percutaneous needle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"59425","name":"Antepartum care only","description":"Antepartum care only; 4-6 visits","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"62252","name":"Csf shunt reprogram","description":"Reprogramming of programmable cerebrospinal shunt","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28001","name":"Drainage of bursa of foot","description":"Incision and drainage, bursa, foot","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"62190","name":"Establish brain cavity shunt","description":"Creation of shunt; subarachnoid/subdural-atrial, -jugular, -auricular","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0480","name":"Basiliximab","description":"Injection, basiliximab, 20 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1410.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15736","name":"Muscle-skin graft arm","description":"Muscle, myocutaneous, or fasciocutaneous flap; upper extremity","date_of_service":"2026-05-10","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":"78608","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); metabolic evaluation","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"Q0112","name":"Potassium hydroxide preps","description":"All potassium hydroxide (koh) preparations","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L0974","name":"Tlso full corset","description":"Tlso, full corset","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92230","name":"Fluorescein angioscopy i&r","description":"Fluorescein angioscopy with interpretation and report","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95860","name":"Needle emg 1 extremity","description":"Needle electromyography; 1 extremity with or without related paraspinal areas","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91030","name":"Acid perfusion of esophagus","description":"Esophagus, acid perfusion (bernstein) test for esophagitis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"0149T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"10121","name":"Inc&rmvl fb subq tiss comp","description":"Incision and removal of foreign body, subcutaneous tissues; complicated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86611","name":"Bartonella antibody","description":"Antibody; bartonella","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"19371","name":"Peri-implt capslc brst compl","description":"Peri-implant capsulectomy, breast, complete, including removal of all intracapsular contents","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":857.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25650","name":"Cltx ulnar styloid fracture","description":"Closed treatment of ulnar styloid fracture","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19200","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1131.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"00632","name":"Anes px lumbar sympathectomy","description":"Anesthesia for procedures in lumbar region; lumbar sympathectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25441","name":"Arthrp w/prostc dstl rds","description":"Arthroplasty with prosthetic replacement; distal radius","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1133.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1002.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86901","name":"Blood typing serologic rh(d)","description":"Blood typing, serologic; rh (d)","date_of_service":"2026-05-10","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":"54680","name":"Relocation of testis(es)","description":"Transplantation of testis(es) to thigh (because of scrotal destruction)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"ATP21","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"61470","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"70330","name":"X-ray exam of jaw joints","description":"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral","date_of_service":"2026-05-10","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":"84460","name":"Alanine amino (alt) (sgpt)","description":"Transferase; alanine amino (alt) (sgpt)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0458","name":"Tlso 2mod symphis-xipho pre","description":"Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagitta","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79200","name":"Nuclear rx intracav admin","description":"Radiopharmaceutical therapy, by intracavitary administration","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5840","name":"Multi-axial knee/shin system","description":"Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","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":"27000","name":"Tenotomy adductor hip perq","description":"Tenotomy, adductor of hip, percutaneous (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"42507","name":"Parotid duct diversion","description":"Parotid duct diversion, bilateral (wilke type procedure);","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6588","name":"Grad com wrap w strap arm","description":"Gradient compression wrap with adjustable straps, arm, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4615","name":"Cannula nasal","description":"Cannula, nasal","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33946","name":"Ecmo/ecls initiation venous","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; initiation, veno-venous","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"57308","name":"Fistula repair transperine","description":"Closure of rectovaginal fistula; transperineal approach, with perineal body reconstruction, with or without levator plication","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":763.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31231","name":"Nasal endoscopy dx","description":"Nasal endoscopy, diagnostic, unilateral or bilateral (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"70552","name":"Mri brain stem w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68760","name":"Close tear duct opening","description":"Closure of the lacrimal punctum; by thermocauterization, ligation, or laser surgery","date_of_service":"2026-05-10","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":"B4185","name":"Pn soln nos 10 grams lipids","description":"Parenteral nutrition solution, not otherwise specified, 10 grams lipids","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"85445","name":"Heinz bodies induced","description":"Heinz bodies; induced, acetyl phenylhydrazine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A7006","name":"Filtered nebulizer admin set","description":"Administration set, with small volume filtered pneumatic nebulizer","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37217","name":"Stent placemt retro carotid","description":"Transcatheter placement of intravascular stent(s), intrathoracic common carotid artery or innominate artery by retrograde treatment, open ipsilateral cervical carotid artery exposure, including angioplasty, when performed, and radiological supervision and interpretation","date_of_service":"2026-05-10","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":"33602","name":"Closure of valve","description":"Closure of semilunar valve (aortic or pulmonary) by suture or patch","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1447.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20520","name":"Rmvl fb musc/tdn simple","description":"Removal of foreign body in muscle or tendon sheath; simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"50365","name":"Rnl altrnsplj w/rcp nfrct","description":"Renal allotransplantation, implantation of graft; with recipient nephrectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0279","name":"Tomosynthesis, mammo","description":"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)","date_of_service":"2026-05-10","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":"41017","name":"Drainage of mouth lesion","description":"Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; submandibular","date_of_service":"2026-05-10","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":"50610","name":"Removal of ureter stone","description":"Ureterolithotomy; upper one-third of ureter","date_of_service":"2026-05-10","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":"30906","name":"Repeat control of nosebleed","description":"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; subsequent","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0236","name":"Pump for water circulating p","description":"Pump for water circulating pad","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":394.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"58322","name":"Artificial insemination","description":"Artificial insemination; intra-uterine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"82103","name":"Alpha-1-antitrypsin total","description":"Alpha-1-antitrypsin; total","date_of_service":"2026-05-10","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":"A5505","name":"Diab shoe w/metatarsal bar","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1653.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":875.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93508","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"33870","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52250","name":"Cystoscopy and radiotracer","description":"Cystourethroscopy with insertion of radioactive substance, with or without biopsy or fulguration","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82010","name":"Ketone bodys quan","description":"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25430","name":"Vasc graft into carpal bone","description":"Insertion of vascular pedicle into carpal bone (eg, hori procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92614","name":"Laryngoscopic sensory vid","description":"Flexible endoscopic evaluation, laryngeal sensory testing by cine or video recording;","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"78807","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"93561","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55680","name":"Remove sperm pouch lesion","description":"Excision of mullerian duct cyst","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0205","name":"Heat lamp with stand","description":"Heat lamp, with stand, includes bulb, or infrared element","date_of_service":"2026-05-10","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":"83033","name":"Hemoglobin ftl f assay qual","description":"Hemoglobin; f (fetal), qualitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35879","name":"Revise graft w/vein","description":"Revision, lower extremity arterial bypass, without thrombectomy, open; with vein patch angioplasty","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42660","name":"Dilation of salivary duct","description":"Dilation and catheterization of salivary duct, with or without injection","date_of_service":"2026-05-10","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":"L5270","name":"Tilt table locking hip sing","description":"Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"29883","name":"Arthrs kne srg mnisc rpr m&l","description":"Arthroscopy, knee, surgical; with meniscus repair (medial and lateral)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":709.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8624","name":"Lith ion batt cid, ear level","description":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6589","name":"Grad com wrap w straps bra","description":"Gradient pressure wrap with adjustable straps, bra, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-10","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":"E1812","name":"Knee ext/flex w act res ctrl","description":"Dynamic knee, extension/flexion device with active resistance control","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"21087","name":"Impres&prep nasal prosth","description":"Impression and custom preparation; nasal prosthesis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2151.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51702","name":"Insert temp bladder cath","description":"Insertion of temporary indwelling bladder catheter; simple (eg, foley)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"59001","name":"Amniocentesis therapeutic","description":"Amniocentesis; therapeutic amniotic fluid reduction (includes ultrasound guidance)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","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":"46505","name":"Chemodenervation anal musc","description":"Chemodenervation of internal anal sphincter","date_of_service":"2026-05-10","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":"75978","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":632.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77404","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58560","name":"Hysteroscopy resect septum","description":"Hysteroscopy, surgical; with division or resection of intrauterine septum (any method)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":884.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"42104","name":"Excision lesion mouth roof","description":"Excision, lesion of palate, uvula; without closure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1297.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"10121","name":"Inc&rmvl fb subq tiss comp","description":"Incision and removal of foreign body, subcutaneous tissues; complicated","date_of_service":"2026-05-10","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":"83069","name":"Hemoglobin urine","description":"Hemoglobin; urine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"53442","name":"Remove/revise male sling","description":"Removal or revision of sling for male urinary incontinence (eg, fascia or synthetic)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6222","name":"Gauze <=16 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"83894","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"27466","name":"Lengthening of thigh bone","description":"Osteoplasty, femur; lengthening","date_of_service":"2026-05-10","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":"94150","name":"Vital capacity test","description":"Vital capacity, total (separate procedure)","date_of_service":"2026-05-10","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":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"73201","name":"Ct upper extremity w/dye","description":"Computed tomography, upper extremity; with contrast material(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90743","name":"Hepb vacc 2 dose adolesc im","description":"Hepatitis b vaccine (hepb), adolescent, 2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","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":82.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51784","name":"Anal/urinary muscle study","description":"Electromyography studies (emg) of anal or urethral sphincter, other than needle, any technique","date_of_service":"2026-05-10","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":"27394","name":"Lengthening of thigh tendons","description":"Lengthening of hamstring tendon; multiple tendons, 1 leg","date_of_service":"2026-05-10","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":"33320","name":"Repair major blood vessel(s)","description":"Suture repair of aorta or great vessels; without shunt or cardiopulmonary bypass","date_of_service":"2026-05-10","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":"73564","name":"X-ray exam knee 4 or more","description":"Radiologic examination, knee; complete, 4 or more views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87015","name":"Specimen infect agnt concntj","description":"Concentration (any type), for infectious agents","date_of_service":"2026-05-10","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":"90834","name":"Psytx w pt 45 minutes","description":"Psychotherapy, 45 minutes with patient","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4248","name":"Chlorhexidine antisept","description":"Chlorhexidine containing antiseptic, 1 ml","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"83992","name":"Assay for phencyclidine","description":"Phencyclidine (pcp)","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"96420","name":"Chemo ia push tecnique","description":"Chemotherapy administration, intra-arterial; push technique","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","date_of_service":"2026-05-10","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":"01140","name":"Anes ntrplvabdmnl amputation","description":"Anesthesia for interpelviabdominal (hindquarter) amputation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.16,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77295","name":"3-d radiotherapy plan","description":"3-dimensional radiotherapy plan, including dose-volume histograms","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1709.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0486","name":"Mon cable elec/pneum vad rep","description":"Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27640","name":"Partial removal of tibia","description":"Partial excision (craterization, saucerization, or diaphysectomy), bone (eg, osteomyelitis); tibia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"42960","name":"Control throat bleeding","description":"Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57130","name":"Excision vaginal septum","description":"Excision of vaginal septum","date_of_service":"2026-05-10","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":"95920","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E0945","name":"Belt/harness extremity","description":"Extremity belt/harness","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32320","name":"Free/remove chest lining","description":"Decortication and parietal pleurectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1774.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59622","name":"Attempted vbac after care","description":"Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery; including postpartum care","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3139.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1821","name":"Replacement interface spsd","description":"Replacement soft interface material/cuffs for bi-directional static progressive stretch device","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"78710","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1932","name":"Afo rig ant tib tcf/= custom","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4360","name":"Disposable ext urethral dev","description":"Disposable external urethral clamp or compression device, with pad and/or pouch, each","date_of_service":"2026-05-10","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":"76641","name":"Ultrasound breast complete","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90470","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"92230","name":"Fluorescein angioscopy i&r","description":"Fluorescein angioscopy with interpretation and report","date_of_service":"2026-05-10","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":"64530","name":"N block inj celiac pelus","description":"Injection, anesthetic agent; celiac plexus, with or without radiologic monitoring","date_of_service":"2026-05-10","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":"77059","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"88160","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; screening and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2128","name":"Kafo fem fx cast molded to p","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1840","name":"Adj shoulder ext/flex device","description":"Dynamic adjustable shoulder flexion / abduction / rotation device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"67415","name":"Aspiration orbital contents","description":"Fine needle aspiration of orbital contents","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77084","name":"Mri bone marrow blood supply","description":"Magnetic resonance (eg, proton) imaging, bone marrow blood supply","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":997.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83625","name":"Assay of ldh enzymes","description":"Lactate dehydrogenase (ld), (ldh); isoenzymes, separation and quantitation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-10","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":"92604","name":"Reprogram cochlear implt 7/>","description":"Diagnostic analysis of cochlear implant, age 7 years or older; subsequent reprogramming","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31051","name":"Sphenoid sinus surgery","description":"Sinusotomy, sphenoid, with or without biopsy; with mucosal stripping or removal of polyp(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0200","name":"Heat lamp without stand","description":"Heat lamp, without stand (table model), includes bulb, or infrared element","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7342","name":"Ciprofloxacin otic susp 6 mg","description":"Instillation, ciprofloxacin otic suspension, 6 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KN"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1405","name":"O2/water vapor enrich w/heat","description":"Oxygen and water vapor enriching system with heated delivery","date_of_service":"2026-05-10","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":"24130","name":"Excision radial head","description":"Excision, radial head","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"G2058","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0105","name":"Colorectal scrn; hi risk ind","description":"Colorectal cancer screening; colonoscopy on individual at high risk","date_of_service":"2026-05-10","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":"T4543","name":"Adult disp brief/diap abv xl","description":"Adult sized disposable incontinence product, protective brief/diaper, above extra large, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0353T","name":"Intraop oct breast cavity","description":"Optical coherence tomography of breast, surgical cavity; real-time intraoperative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"46070","name":"Incision anal septum infant","description":"Incision, anal septum (infant)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","date_of_service":"2026-05-10","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":"E0635","name":"Patient lift electric","description":"Patient lift, electric with seat or sling","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64818","name":"Sympathectomy lumbar","description":"Sympathectomy, lumbar","date_of_service":"2026-05-10","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":"54390","name":"Repair penis and bladder","description":"Plastic operation on penis for epispadias distal to external sphincter; with exstrophy of bladder","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1422.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":745.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1261.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1350.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":225.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25040","name":"Arthrt rdcrpl/midcarpl jt","description":"Arthrotomy, radiocarpal or midcarpal joint, with exploration, drainage, or removal of foreign body","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90829","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"49080","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45825","name":"Repair fistula w/colostomy","description":"Closure of rectourethral fistula; with colostomy","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64640","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent; other peripheral nerve or branch","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00916","name":"Anes trurl px rescj bleeding","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); post-transurethral resection bleeding","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78480","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92584","name":"Electrocochleography","description":"Electrocochleography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95912","name":"Nrv cndj test 11-12 studies","description":"Nerve conduction studies; 11-12 studies","date_of_service":"2026-05-10","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":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2125.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82160","name":"Assay of androsterone","description":"Androsterone","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":561.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":989.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"51726","name":"Complex cystometrogram","description":"Complex cystometrogram (ie, calibrated electronic equipment);","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6920","name":"Wrist disarticul switch ctrl","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","date_of_service":"2026-05-10","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":"29886","name":"Arthrs knee surg drlg od les","description":"Arthroscopy, knee, surgical; drilling for intact osteochondritis dissecans lesion","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01462","name":"Anes clsd px lower l/a/f","description":"Anesthesia for all closed procedures on lower leg, ankle, and foot","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2017.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88164","name":"Cytopath tbs c/v manual","description":"Cytopathology, slides, cervical or vaginal (the bethesda system); manual screening under physician supervision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-10","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":"83876","name":"Assay myeloperoxidase","description":"Myeloperoxidase (mpo)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":514.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"86431","name":"Rheumatoid factor quant","description":"Rheumatoid factor; quantitative","date_of_service":"2026-05-10","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":"21406","name":"Opn tx orbit fx w/o implant","description":"Open treatment of fracture of orbit, except blowout; without implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":"64653","name":"Chemodenerv eccrine glands","description":"Chemodenervation of eccrine glands; other area(s) (eg, scalp, face, neck), per day","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-10","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":"42802","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1611.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"28108","name":"Removal of toe lesions","description":"Excision or curettage of bone cyst or benign tumor, phalanges of foot","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64746","name":"Incise diaphragm nerve","description":"Transection or avulsion of; phrenic nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94350","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82710","name":"Fats/lipids feces quant","description":"Fat or lipids, feces; quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83970","name":"Assay of parathormone","description":"Parathormone (parathyroid hormone)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32151","name":"Remove lung foreign body","description":"Thoracotomy; with removal of intrapulmonary foreign body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":714.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"32605","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":482.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86711","name":"John cunningham antibody","description":"Antibody; jc (john cunningham) virus","date_of_service":"2026-05-10","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":"00730","name":"Anes px upper pst abdl wall","description":"Anesthesia for procedures on upper posterior abdominal wall","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3935.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"29887","name":"Arthrs knee srg drlg od fixj","description":"Arthroscopy, knee, surgical; drilling for intact osteochondritis dissecans lesion with internal fixation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1230","name":"Power operated vehicle","description":"Power operated vehicle (three or four wheel nonhighway) specify brand name and model number","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"93722","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"45303","name":"Proctosigmoidoscopy dilate","description":"Proctosigmoidoscopy, rigid; with dilation (eg, balloon, guide wire, bougie)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4252","name":"Blood ketone test or strip","description":"Blood ketone test or reagent strip, each","date_of_service":"2026-05-10","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":"45400","name":"Laparoscopic proc","description":"Laparoscopy, surgical; proctopexy (for prolapse)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1237.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1210","name":"Lateral thoracic extension","description":"Addition to tlso, (low profile), lateral thoracic extension","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":931.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4575","name":"Hyperbaric o2 chamber disps","description":"Topical hyperbaric oxygen chamber, disposable","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-10","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":"L3962","name":"Sewho erbs palsey design abd","description":"Shoulder elbow wrist hand orthosis, abduction positioning, erbs palsey design, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"51065","name":"Remove ureter calculus","description":"Cystotomy, with calculus basket extraction and/or ultrasonic or electrohydraulic fragmentation of ureteral calculus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0920","name":"Fracture frame attached to b","description":"Fracture frame, attached to bed, includes weights","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":869.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":940.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6545","name":"Grad com non-elastic bk surg","description":"Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["AW"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":955.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":415.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8603","name":"Collagen imp urinary 2.5 ml","description":"Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2541.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2226.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2430","name":"Knee jnt ratchet lock ea jnt","description":"Addition to knee joint, ratchet lock for active and progressive knee extension, each joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"73615","name":"Contrast x-ray of ankle","description":"Radiologic examination, ankle, arthrography, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74181","name":"Mri abdomen w/o contrast","description":"Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97113","name":"Aquatic therapy/exercises","description":"Therapeutic procedure, 1 or more areas, each 15 minutes; aquatic therapy with therapeutic exercises","date_of_service":"2026-05-10","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":"79445","name":"Nuclear rx intra-arterial","description":"Radiopharmaceutical therapy, by intra-arterial particulate administration","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92358","name":"Aphakia prosth service temp","description":"Prosthesis service for aphakia, temporary (disposable or loan, including materials)","date_of_service":"2026-05-10","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":"84460","name":"Alanine amino (alt) (sgpt)","description":"Transferase; alanine amino (alt) (sgpt)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3971","name":"Sewho cap design w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q0494","name":"Emr hd pmp elec/combo, rep","description":"Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"67924","name":"Repair eyelid defect","description":"Repair of entropion; extensive (eg, tarsal strip or capsulopalpebral fascia repairs operation)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"44660","name":"Repair bowel-bladder fistula","description":"Closure of enterovesical fistula; without intestinal or bladder resection","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"L5785","name":"Exoskeletal bk ultralt mater","description":"Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82525","name":"Assay of copper","description":"Copper","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":481.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21245","name":"Reconstruction of jaw","description":"Reconstruction of mandible or maxilla, subperiosteal implant; partial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"35494","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":588.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91112","name":"Gi wireless capsule measure","description":"Gastrointestinal transit and pressure measurement, stomach through colon, wireless capsule, with interpretation and report","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":996.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-10","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":"92571","name":"Filtered speech test","description":"Filtered speech test","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"99355","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"V5241","name":"Dispensing fee, monaural","description":"Dispensing fee, monaural hearing aid, any type","date_of_service":"2026-05-10","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":"41806","name":"Removal foreign body jawbone","description":"Removal of embedded foreign body from dentoalveolar structures; bone","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"59070","name":"Transabdom amnioinfus w/us","description":"Transabdominal amnioinfusion, including ultrasound guidance","date_of_service":"2026-05-10","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":"28666","name":"Treat toe dislocation","description":"Percutaneous skeletal fixation of interphalangeal joint dislocation, with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":270.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01916","name":"Anes dx arteriography/vngrph","description":"Anesthesia for diagnostic arteriography/venography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"29035","name":"Appl body cast sho to hips","description":"Application of body cast, shoulder to hips;","date_of_service":"2026-05-10","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":"E1230","name":"Power operated vehicle","description":"Power operated vehicle (three or four wheel nonhighway) specify brand name and model number","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"44389","name":"Colonoscopy with biopsy","description":"Colonoscopy through stoma; with biopsy, single or multiple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"L0641","name":"Lo rig pos pnl l1-l5 pre ots","description":"Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabrica","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78588","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"70010","name":"Contrast x-ray of brain","description":"Myelography, posterior fossa, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97012","name":"Mechanical traction therapy","description":"Application of a modality to 1 or more areas; traction, mechanical","date_of_service":"2026-05-10","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":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":779.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0745","name":"Neuromuscular stim for shock","description":"Neuromuscular stimulator, electronic shock unit","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84152","name":"Assay of psa complexed","description":"Prostate specific antigen (psa); complexed (direct measurement)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":642.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1137.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36262","name":"Removal of infusion pump","description":"Removal of implanted intra-arterial infusion pump","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"48005","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2853.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5420","name":"Postop dsg & 1 cast chg ak/d","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change ak or knee disarticulation","date_of_service":"2026-05-10","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":"V2311","name":"Lens sphc trifo 7.25-12/.25-","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KC"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4141.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1282.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"G0166","name":"Extrnl counterpulse, per tx","description":"External counterpulsation, per treatment session","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8417","name":"Pros sheath/sock w gel cushn","description":"Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"29806","name":"Sho arthrs srg capsulorraphy","description":"Arthroscopy, shoulder, surgical; capsulorrhaphy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1277.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01462","name":"Anes clsd px lower l/a/f","description":"Anesthesia for all closed procedures on lower leg, ankle, and foot","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77413","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87158","name":"Culture typing added method","description":"Culture, typing; other methods","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49582","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0512","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","date_of_service":"2026-05-10","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":"47130","name":"Partial removal of liver","description":"Hepatectomy, resection of liver; total right lobectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3602.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71120","name":"X-ray exam breastbone 2/>vws","description":"Radiologic examination; sternum, minimum of 2 views","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86430","name":"Rheumatoid factor test qual","description":"Rheumatoid factor; qualitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"V2112","name":"Spherocylindr 7.25d/2.25-4d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7403","name":"Add ue prost b/e acrylic","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2576.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-10","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":"E1190","name":"Wheelchair amputee w/ leg re","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable elevating legrests","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85540","name":"Wbc alkaline phosphatase","description":"Leukocyte alkaline phosphatase with count","date_of_service":"2026-05-10","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":"86316","name":"Immunoassay tumor other","description":"Immunoassay for tumor antigen, other antigen, quantitative (eg, ca 50, 72-4, 549), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"43246","name":"Egd place gastrostomy tube","description":"Esophagogastroduodenoscopy, flexible, transoral; with directed placement of percutaneous gastrostomy tube","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-05-10","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":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25259","name":"Manipulate wrist w/anesthes","description":"Manipulation, wrist, under anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":465.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36822","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"45387","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":462.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"81285","name":"Fxn gene charac alleles","description":"Fxn (frataxin) (eg, friedreich ataxia) gene analysis; characterization of alleles (eg, expanded size)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95829","name":"Surgery electrocorticogram","description":"Electrocorticogram at surgery (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1770.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":646.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9181","name":"Etoposide injection","description":"Injection, etoposide, 10 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84075","name":"Assay alkaline phosphatase","description":"Phosphatase, alkaline;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1425.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"87620","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"89320","name":"Semen anal vol/count/mot","description":"Semen analysis; volume, count, motility, and differential","date_of_service":"2026-05-10","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":"01742","name":"Anes opn/arthrs elbw osteot","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; osteotomy of humerus","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0106","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":746.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76873","name":"Echograp trans r pros study","description":"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76514","name":"Echo exam of eye thickness","description":"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"47136","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3397.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78660","name":"Nuclear exam of tear flow","description":"Radiopharmaceutical dacryocystography","date_of_service":"2026-05-10","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":"52300","name":"Cystoscopy and treatment","description":"Cystourethroscopy; with resection or fulguration of orthotopic ureterocele(s), unilateral or bilateral","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0190","name":"Cerv collar supp adj cerv ba","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11981","name":"Insertion drug dlvr implant","description":"Insertion, drug-delivery implant (ie, bioresorbable, biodegradable, non-biodegradable)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2793.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1357.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"L5724","name":"Knee-shin exo fluid swing ph","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-10","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":"L8420","name":"Prosthetic sock multi ply bk","description":"Prosthetic sock, multiple ply, below knee, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"J3303","name":"Triamcinolone hexacetonl inj","description":"Injection, triamcinolone hexacetonide, per 5 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1808.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44145","name":"Partial removal of colon","description":"Colectomy, partial; with coloproctostomy (low pelvic anastomosis)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1357.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61480","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","date_of_service":"2026-05-10","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":"00830","name":"Anes hernia rpr lwr abd nos","description":"Anesthesia for hernia repairs in lower abdomen; not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":683.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99357","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5083","name":"Stoma absorptive cover","description":"Continent device, stoma absorptive cover for continent stoma","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2237.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54505","name":"Biopsy of testis","description":"Biopsy of testis, incisional (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35875","name":"Removal of clot in graft","description":"Thrombectomy of arterial or venous graft (other than hemodialysis graft or fistula);","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65265","name":"Remove foreign body from eye","description":"Removal of foreign body, intraocular; from posterior segment, nonmagnetic extraction","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"15793","name":"Chemical peel nonfacial drm","description":"Chemical peel, nonfacial; dermal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":374.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1612.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88311","name":"Decalcify tissue","description":"Decalcification procedure (list separately in addition to code for surgical pathology examination)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28340","name":"Resect enlarged toe tissue","description":"Reconstruction, toe, macrodactyly; soft tissue resection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"23210","name":"Radical rescj tumor scapula","description":"Radical resection of tumor; scapula","date_of_service":"2026-05-10","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":"27347","name":"Remove knee cyst","description":"Excision of lesion of meniscus or capsule (eg, cyst, ganglion), knee","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":557.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1813","name":"Adjust knee extension device","description":"Dynamic adjustable knee extension only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70498","name":"Ct angiography neck","description":"Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77051","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"88356","name":"Analysis nerve","description":"Morphometric analysis; nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78130","name":"Red cell survival study","description":"Red cell survival study","date_of_service":"2026-05-10","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":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"49255","name":"Removal of omentum","description":"Omentectomy, epiploectomy, resection of omentum (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":810.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6266","name":"Impreg gauze no h20/sal/yard","description":"Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"31755","name":"Trachplsty trchphryngl fstlj","description":"Tracheoplasty; tracheopharyngeal fistulization, each stage","date_of_service":"2026-05-10","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":"L6639","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70330","name":"X-ray exam of jaw joints","description":"Radiologic examination, temporomandibular joint, open and closed mouth; bilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1021.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22222","name":"Osteot dsc ant 1vrt sgm thrc","description":"Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; thoracic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"42220","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate; secondary lengthening procedure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2782","name":"Lens, 1.54-1.65 p/1.60-1.79g","description":"Lens, index 1.54 to 1.65 plastic or 1.60 to 1.79 glass, excludes polycarbonate, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1111.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1612.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37221","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"15342","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1940","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"77285","name":"Ther rad simulaj field intrm","description":"Therapeutic radiology simulation-aided field setting; intermediate","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0472","name":"Tlso rigid frame hyperex pre","description":"Tlso, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coro","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.26,"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":"21336","name":"Open tx septal fx w/wo stabj","description":"Open treatment of nasal septal fracture, with or without stabilization","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":728.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1228","name":"Wheelchair spec sz spec ht b","description":"Special back height for wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1092.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2501.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1702","name":"Repl measr scales jaw motion","description":"Replacement measuring scales for jaw motion rehabilitation system, pkg. of 200","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1226.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"J3410","name":"Hydroxyzine hcl injection","description":"Injection, hydroxyzine hcl, up to 25 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1823","name":"Adjust ankle flexion device","description":"Dynamic adjustable ankle flexion only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1518.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-10","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":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73010","name":"X-ray exam of shoulder blade","description":"Radiologic examination; scapula, complete","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"42831","name":"Removal of adenoids","description":"Adenoidectomy, primary; age 12 or over","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0462","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"77310","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":565.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6447","name":"Conform band s w >=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard","date_of_service":"2026-05-10","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":"00500","name":"Anes all px on esophagus","description":"Anesthesia for all procedures on esophagus","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":364.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":335.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4100","name":"Repl leath cuff kafo prox th","description":"Replace leather cuff kafo, proximal thigh","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"27614","name":"Biopsy lower leg soft tissue","description":"Biopsy, soft tissue of leg or ankle area; deep (subfascial or intramuscular)","date_of_service":"2026-05-10","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":"67316","name":"Revise two eye muscles","description":"Strabismus surgery, recession or resection procedure; 2 or more vertical muscles (excluding superior oblique)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":780.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"00470","name":"Anes partial rib rescj nos","description":"Anesthesia for partial rib resection; not otherwise specified","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":561.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50546","name":"Laparoscopic nephrectomy","description":"Laparoscopy, surgical; nephrectomy, including partial ureterectomy","date_of_service":"2026-05-10","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":"E0291","name":"Hosp bed fx ht w/o rail w/o","description":"Hospital bed, fixed height, without side rails, without mattress","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"26548","name":"Reconstruct finger joint","description":"Repair and reconstruction, finger, volar plate, interphalangeal joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3917","name":"Metacarp fx orthosis pre cst","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J1080","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"23031","name":"I&d shoulder infected bursa","description":"Incision and drainage, shoulder area; infected bursa","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5603.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"33675","name":"Close mult vsd","description":"Closure of multiple ventricular septal defects;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0239","name":"Hydrocollator unit portable","description":"Hydrocollator unit, portable","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3702","name":"Eo w/o joints cf","description":"Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29877","name":"Arthrs knee surg dbrdmt/shvg","description":"Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"23174","name":"Sqstrctmy humrl head srg nck","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), humeral head to surgical neck","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"73564","name":"X-ray exam knee 4 or more","description":"Radiologic examination, knee; complete, 4 or more views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74420","name":"Urography rtrgr +-kub","description":"Urography, retrograde, with or without kub","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"40844","name":"Reconstruction of mouth","description":"Vestibuloplasty; entire arch","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1330.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2154.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4015","name":"Cast sup gauntlet ped plster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), plaster","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87168","name":"Macroscopic exam arthropod","description":"Macroscopic examination; arthropod","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1424.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75842","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-10","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":"84157","name":"Assay of protein other","description":"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7509","name":"Methylprednisolone oral","description":"Methylprednisolone oral, per 4 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73000","name":"X-ray exam of collar bone","description":"Radiologic examination; clavicle, complete","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":"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":"2026-05-10","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":"40525","name":"Reconstruct lip with flap","description":"Excision of lip; full thickness, reconstruction with local flap (eg, estlander or fan)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"00832","name":"Anes hernia repair vnt&incal","description":"Anesthesia for hernia repairs in lower abdomen; ventral and incisional hernias","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2753.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"00820","name":"Anes px lwr post abdl wall","description":"Anesthesia for procedures on lower posterior abdominal wall","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"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":"2026-05-10","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":"78580","name":"Lung perfusion imaging","description":"Pulmonary perfusion imaging (eg, particulate)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-10","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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"24900","name":"Amputation of upper arm","description":"Amputation, arm through humerus; with primary closure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"76930","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"76391","name":"Mr elastography","description":"Magnetic resonance (eg, vibration) elastography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38525","name":"Biopsy/removal lymph nodes","description":"Biopsy or excision of lymph node(s); open, deep axillary node(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1274.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0042T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"00844","name":"Anes iper px abdmnprnl rescj","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; abdominoperineal resection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"00950","name":"Anes vag px culdoscopy","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); culdoscopy","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5540","name":"Prep bk ptb laminated socket","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35485","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45108","name":"Anorectal myomectomy","description":"Anorectal myomectomy","date_of_service":"2026-05-10","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":"J1564","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1031","name":"Rollabout chair with casters","description":"Rollabout chair, any and all types with casters 5 or greater","date_of_service":"2026-05-10","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":"74245","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3921","name":"Hfo w/joint(s) cf","description":"Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":837.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"77075","name":"Radex osseous survey compl","description":"Radiologic examination, osseous survey; complete (axial and appendicular skeleton)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"92330","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58562","name":"Hysteroscopy remove fb","description":"Hysteroscopy, surgical; with removal of impacted foreign body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92283","name":"Extnd color vision xm","description":"Color vision examination, extended, eg, anomaloscope or equivalent","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"95913","name":"Nrv cndj test 13/> studies","description":"Nerve conduction studies; 13 or more studies","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-10","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":"83605","name":"Assay of lactic acid","description":"Lactate (lactic acid)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27095","name":"Injection for hip x-ray","description":"Injection procedure for hip arthrography; with anesthesia","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6452","name":"High compres band w>=3in<5inyd","description":"High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4017","name":"Cast sup lng arm splint plst","description":"Cast supplies, long arm splint, adult (11 years +), plaster","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":287.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29838","name":"Elbow arthroscopy/surgery","description":"Arthroscopy, elbow, surgical; debridement, extensive","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33246","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1499.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1080","name":"Outrigger","description":"Addition to ctlso or scoliosis orthosis, outrigger","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3020","name":"Foot longitud/metatarsal sup","description":"Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26437","name":"Realignment of tendons","description":"Realignment of extensor tendon, hand, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2048.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":768.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2171.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50040","name":"Nfros nfrot w/drg","description":"Nephrostomy, nephrotomy with drainage","date_of_service":"2026-05-10","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":"70547","name":"Mr angiography neck w/o dye","description":"Magnetic resonance angiography, neck; without contrast material(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":647.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0585","name":"Nebulizer w/ compressor & he","description":"Nebulizer, with compressor and heater","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"73060","name":"X-ray exam of humerus","description":"Radiologic examination; humerus, minimum of 2 views","date_of_service":"2026-05-10","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":"72255","name":"Myelography thoracic spine","description":"Myelography, thoracic, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51772","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4396","name":"Peristomal hernia supprt blt","description":"Ostomy belt with peristomal hernia support","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0297","name":"Hosp bed total elect w/o mat","description":"Hospital bed, total electric (head, foot and height adjustments), without side rails, without mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":951.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78104","name":"Bone marrow imaging body","description":"Bone marrow imaging; whole body","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A7015","name":"Aerosol mask used w nebulize","description":"Aerosol mask, used with dme nebulizer","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5510","name":"Prep bk ptb plaster molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":529.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1477.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"B9000","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"75968","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2580.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":662.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"78584","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33130","name":"Rescj external cardiac tumor","description":"Resection of external cardiac tumor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1537.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84443","name":"Assay thyroid stim hormone","description":"Thyroid stimulating hormone (tsh)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-10","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":"74470","name":"X-ray exam of kidney lesion","description":"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"95056","name":"Photo tests","description":"Photo tests","date_of_service":"2026-05-10","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":"33730","name":"Repair heart-vein defect(s)","description":"Complete repair of anomalous pulmonary venous return (supracardiac, intracardiac, or infracardiac types)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2386.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","date_of_service":"2026-05-10","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":"L5816","name":"Endo knee-shin polyc mch sta","description":"Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73564","name":"X-ray exam knee 4 or more","description":"Radiologic examination, knee; complete, 4 or more views","date_of_service":"2026-05-10","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":"49180","name":"Biopsy abdominal mass","description":"Biopsy, abdominal or retroperitoneal mass, percutaneous needle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"77610","name":"Hyperthermia ntrstl prb 5/<","description":"Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0073T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":873.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"70100","name":"X-ray exam of jaw <4views","description":"Radiologic examination, mandible; partial, less than 4 views","date_of_service":"2026-05-10","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":"Q0489","name":"Pwr pck base combo vad, rep","description":"Power pack base for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5695","name":"Ak sleeve susp neoprene/equa","description":"Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00537","name":"Anes cardiac ep procedures","description":"Anesthesia for cardiac electrophysiologic procedures including radiofrequency ablation","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"85378","name":"Fibrin degrade semiquant","description":"Fibrin degradation products, d-dimer; qualitative or semiquantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"82747","name":"Assay of folic acid rbc","description":"Folic acid; rbc","date_of_service":"2026-05-10","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":"A4384","name":"Ostomy faceplt/silicone ring","description":"Ostomy faceplate equivalent, silicone ring, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2110","name":"Spherocylinder 4.25d/over 6d","description":"Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1240","name":"Dimenhydrinate injection","description":"Injection, dimenhydrinate, up to 50 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J7100","name":"Dextran 40 infusion","description":"Infusion, dextran 40, 500 ml","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"76102","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-10","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":"53661","name":"Dilation of urethra","description":"Dilation of female urethra including suppository and/or instillation; subsequent","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96422","name":"Chemo ia infusion up to 1 hr","description":"Chemotherapy administration, intra-arterial; infusion technique, up to 1 hour","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"27510","name":"Treatment of thigh fracture","description":"Closed treatment of femoral fracture, distal end, medial or lateral condyle, with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":574.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29871","name":"Arthrs knee surg for infctj","description":"Arthroscopy, knee, surgical; for infection, lavage and drainage","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7040","name":"Prehensile actuator","description":"Prehensile actuator, switch controlled","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1715.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"3075F","name":"Syst bp ge 130 - 139mm hg","description":"Most recent systolic blood pressure 130-139 mm hg (dm) (htn, ckd, cad)","date_of_service":"2026-05-10","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":2.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0623","name":"Sio rig pnl pelv/sac pre ots","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1682.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":786.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4390","name":"Drainable pch ex wear convex","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-10","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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3557.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","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":"E0238","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-10","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":"44346","name":"Revision of colostomy","description":"Revision of colostomy; with repair of paracolostomy hernia (separate procedure)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82164","name":"Angiotensin i enzyme test","description":"Angiotensin i - converting enzyme (ace)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45402","name":"Lap proctopexy w/sig resect","description":"Laparoscopy, surgical; proctopexy (for prolapse), with sigmoid resection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1213.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00142","name":"Anes px on eye lens surgery","description":"Anesthesia for procedures on eye; lens surgery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"93010","name":"Electrocardiogram report","description":"Electrocardiogram, routine ecg with at least 12 leads; interpretation and report only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43192","name":"Esophagoscp rig trnso inject","description":"Esophagoscopy, rigid, transoral; with directed submucosal injection(s), any substance","date_of_service":"2026-05-10","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":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-05-10","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":"82003","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"92518","name":"Vemp test i&r ocular","description":"Vestibular evoked myogenic potential (vemp) testing, with interpretation and report; ocular (ovemp)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1137.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1511.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33889","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83937","name":"Assay of osteocalcin","description":"Osteocalcin (bone g1a protein)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0389","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19272","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90828","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2813.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4617","name":"Mouth piece","description":"Mouth piece","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1433.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78601","name":"Brain image w/flow < 4 views","description":"Brain imaging, less than 4 static views; with vascular flow","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":636.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5211.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G2066","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"23500","name":"Cltx clavicular fx w/o mnpj","description":"Closed treatment of clavicular fracture; without manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87910","name":"Nfct agt gntyp alys cmv","description":"Infectious agent genotype analysis by nucleic acid (dna or rna); cytomegalovirus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0468","name":"Tlso rig fram pelvic pre cst","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal, and coronal","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"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":"2026-05-10","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":"74263","name":"Ct colonography screening","description":"Computed tomographic (ct) colonography, screening, including image postprocessing","date_of_service":"2026-05-10","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":"96406","name":"Chemo intralesional over 7","description":"Chemotherapy administration; intralesional, more than 7 lesions","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"L6639","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"90814","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":402.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":"L3230","name":"Custom shoes depth inlay","description":"Orthopedic footwear, custom shoe, depth inlay, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KM"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2770","name":"Quinupristin/dalfopristin","description":"Injection, quinupristin/dalfopristin, 500 mg (150/350)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91034","name":"Gastroesophageal reflux test","description":"Esophagus, gastroesophageal reflux test; with nasal catheter ph electrode(s) placement, recording, analysis and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1272.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6708","name":"Term dev mech hand vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0205","name":"Heat lamp with stand","description":"Heat lamp, with stand, includes bulb, or infrared element","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"84600","name":"Assay of volatiles","description":"Volatiles (eg, acetic anhydride, diethylether)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4453","name":"Rec cath any transanal, each","description":"Rectal catheter with or without balloon, for use with any type transanal irrigation system, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","date_of_service":"2026-05-10","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":"25405","name":"Repair/graft radius or ulna","description":"Repair of nonunion or malunion, radius or ulna; with autograft (includes obtaining graft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1559.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"88366","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; each multiplex probe stain procedure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"E0740","name":"Non-implant pelv flr e-stim","description":"Non-implanted pelvic floor electrical stimulator, complete system","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1353","name":"Oxygen supplies regulator","description":"Regulator","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"43600","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00910","name":"Anes transurethral px nos","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1086.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25492","name":"Prophylactic tx radius&ulna","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; radius and ulna","date_of_service":"2026-05-10","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":"40808","name":"Biopsy of mouth lesion","description":"Biopsy, vestibule of mouth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92250","name":"Fundus photography w/i&r","description":"Fundus photography with interpretation and report","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"54125","name":"Removal of penis","description":"Amputation of penis; complete","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1550.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"50135","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1234.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-10","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":"L1825","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"82360","name":"Calculus assay quant","description":"Calculus; quantitative analysis, chemical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","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":"32906","name":"Revise & repair chest wall","description":"Thoracoplasty, schede type or extrapleural (all stages); with closure of bronchopleural fistula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1910.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"34401","name":"Removal of vein clot","description":"Thrombectomy, direct or with catheter; vena cava, iliac vein, by abdominal incision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1713.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"77057","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1160","name":"Wheelchair fixed arms","description":"Wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53085","name":"Drainage of urinary leakage","description":"Drainage of perineal urinary extravasation; complicated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":828.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"86645","name":"Cmv antibody igm","description":"Antibody; cytomegalovirus (cmv), igm","date_of_service":"2026-05-10","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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30920","name":"Ligation upper jaw artery","description":"Ligation arteries; internal maxillary artery, transantral","date_of_service":"2026-05-10","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":"67414","name":"Explr/decompress eye socket","description":"Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of bone for decompression","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":845.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88272","name":"Cytogenetics 3-5","description":"Molecular cytogenetics; chromosomal in situ hybridization, analyze 3-5 cells (eg, for derivatives and markers)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67924","name":"Repair eyelid defect","description":"Repair of entropion; extensive (eg, tarsal strip or capsulopalpebral fascia repairs operation)","date_of_service":"2026-05-10","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":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"43243","name":"Egd injection varices","description":"Esophagogastroduodenoscopy, flexible, transoral; with injection sclerosis of esophageal/gastric varices","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":797.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74475","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6531","name":"Compress stking bk30-40 surg","description":"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["AW","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73551","name":"X-ray exam of femur 1","description":"Radiologic examination, femur; 1 view","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46916","name":"Cryosurgery anal lesion(s)","description":"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; cryosurgery","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6660","name":"Heavy duty control cable","description":"Upper extremity addition, heavy duty control cable","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21050","name":"Removal of jaw joint","description":"Condylectomy, temporomandibular joint (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83030","name":"Hemoglobin f fetal chemical","description":"Hemoglobin; f (fetal), chemical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"67112","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1298.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"23000","name":"Rmvl sbdltd clcreous dep opn","description":"Removal of subdeltoid calcareous deposits, open","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94726","name":"Plethysmography lung volumes","description":"Plethysmography for determination of lung volumes and, when performed, airway resistance","date_of_service":"2026-05-10","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":"27536","name":"Treat knee fracture","description":"Open treatment of tibial fracture, proximal (plateau); bicondylar, with or without internal fixation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1006.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4410","name":"Ost skn barr extnd >4 sq","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP07","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77620","name":"Hyperthermia gen intrcv prb","description":"Hyperthermia generated by intracavitary probe(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"31515","name":"Laryngoscopy for aspiration","description":"Laryngoscopy direct, with or without tracheoscopy; for aspiration","date_of_service":"2026-05-10","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":"82378","name":"Carcinoembryonic antigen","description":"Carcinoembryonic antigen (cea)","date_of_service":"2026-05-10","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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","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":"32664","name":"Thoracoscopy w/ th nrv exc","description":"Thoracoscopy, surgical; with thoracic sympathectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1093.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84620","name":"Xylose tolerance test","description":"Xylose absorption test, blood and/or urine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"J8501","name":"Oral aprepitant","description":"Aprepitant, oral, 5 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":740.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90713","name":"Poliovirus ipv sc/im","description":"Poliovirus vaccine, inactivated (ipv), for subcutaneous or intramuscular use","date_of_service":"2026-05-10","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":54.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27250","name":"Treat hip dislocation","description":"Closed treatment of hip dislocation, traumatic; without anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"89055","name":"Leukocyte assessment fecal","description":"Leukocyte assessment, fecal, qualitative or semiquantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"J1270","name":"Injection, doxercalciferol","description":"Injection, doxercalciferol, 1 mcg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0115","name":"Post-coital mucous exam","description":"Post-coital direct, qualitative examinations of vaginal or cervical mucous","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2282.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9490","name":"Cmmi mod home visit","description":"Cms innovation center models, home visit for patient assessment performed by clinical staff for an individual not considered homebound, including, but not necessarily limited to patient assessment of clinical status, safety/fall prevention, functional status/ambulation, medication reconciliation/man","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1774.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"15175","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43352","name":"Surgical opening esophagus","description":"Esophagostomy, fistulization of esophagus, external; cervical approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1147.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J8520","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0206","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2636.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"00702","name":"Anes upr ant abd wall lvr bx","description":"Anesthesia for procedures on upper anterior abdominal wall; percutaneous liver biopsy","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1452.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"87001","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64870","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1147.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-10","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":"33870","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"70190","name":"X-ray exam of eye sockets","description":"Radiologic examination; optic foramina","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"S3835","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"90740","name":"Hepb vacc 3 dose immunsup im","description":"Hepatitis b vaccine (hepb), dialysis or immunosuppressed patient dosage, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","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":223.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","date_of_service":"2026-05-10","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":"01654","name":"Anes art sho&ax bypass grf","description":"Anesthesia for procedures on arteries of shoulder and axilla; bypass graft","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":"25671","name":"Perq skel fix rad/uln dislc","description":"Percutaneous skeletal fixation of distal radioulnar dislocation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"L0140","name":"Cervical semi-rigid adjustab","description":"Cervical, semi-rigid, adjustable (plastic collar)","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","date_of_service":"2026-05-10","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":"71100","name":"X-ray exam ribs uni 2 views","description":"Radiologic examination, ribs, unilateral; 2 views","date_of_service":"2026-05-10","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":"91052","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","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":"2026-05-10","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":"44603","name":"Suture small intestine","description":"Suture of small intestine (enterorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture; multiple perforations","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76978","name":"Us trgt dyn mbubb 1st les","description":"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5812","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21260","name":"Revise eye sockets","description":"Periorbital osteotomies for orbital hypertelorism, with bone grafts; extracranial approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1340.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"70140","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; less than 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":713.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0501","name":"Shwr cov elec/combo vad, rep","description":"Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1207.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2306","name":"Lens sphcyl trifocal 4.00/>6","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-10","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":"75746","name":"Artery x-rays lung","description":"Angiography, pulmonary, by nonselective catheter or venous injection, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85210","name":"Clot factor ii prothrom spec","description":"Clotting; factor ii, prothrombin, specific","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95868","name":"Ndl emg cranial nrv musc bi","description":"Needle electromyography; cranial nerve supplied muscles, bilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1846","name":"Ko w adj flex/ext rotat mold","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":634.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4480","name":"Vabra aspirator","description":"Vabra aspirator","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"91111","name":"Gi trc img intral esophagus","description":"Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus with interpretation and report","date_of_service":"2026-05-10","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":"53449","name":"Repair uro sphincter","description":"Repair of inflatable urethral/bladder neck sphincter, including pump, reservoir, and cuff","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":662.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"38794","name":"Access thoracic lymph duct","description":"Cannulation, thoracic duct","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":364.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0418","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8199.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4245","name":"Alcohol wipes per box","description":"Alcohol wipes, per box","date_of_service":"2026-05-10","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":"15170","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57270","name":"Repair of bowel pouch","description":"Repair of enterocele, abdominal approach (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":880.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6606","name":"G com bandage padded textile","description":"Gradient compression bandaging supply, padded textile, per linear yard, any width, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88272","name":"Cytogenetics 3-5","description":"Molecular cytogenetics; chromosomal in situ hybridization, analyze 3-5 cells (eg, for derivatives and markers)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01638","name":"Anes opn/arthr tot sho rplcm","description":"Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; total shoulder replacement","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33425","name":"Repair of mitral valve","description":"Valvuloplasty, mitral valve, with cardiopulmonary bypass;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01670","name":"Anes all px vn shoulder&ax","description":"Anesthesia for all procedures on veins of shoulder and axilla","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94728","name":"Airwy resist by oscillometry","description":"Airway resistance by oscillometry","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70030","name":"X-ray eye for foreign body","description":"Radiologic examination, eye, for detection of foreign body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75896","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"88187","name":"Flowcytometry/read 2-8","description":"Flow cytometry, interpretation; 2 to 8 markers","date_of_service":"2026-05-10","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":"51580","name":"Remove bladder/revise tract","description":"Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous transplantations;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1533.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54015","name":"I&d penis deep","description":"Incision and drainage of penis, deep","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1232.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63280","name":"Bx/exc idrl spine lesn crvl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, cervical","date_of_service":"2026-05-10","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":"00873","name":"Anes lithotrp esw wo wtr bth","description":"Anesthesia for lithotripsy, extracorporeal shock wave; without water bath","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4315","name":"Cath w/drainage 2-way silcne","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone","date_of_service":"2026-05-10","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":"25690","name":"Cltx lunate dislc w/mnpj","description":"Closed treatment of lunate dislocation, with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"78016","name":"Thyroid met imaging/studies","description":"Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"65435","name":"Curette/treat cornea","description":"Removal of corneal epithelium; with or without chemocauterization (abrasion, curettage)","date_of_service":"2026-05-10","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":"60600","name":"Remove carotid body lesion","description":"Excision of carotid body tumor; without excision of carotid artery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62272","name":"Ther spi pnxr drg csf","description":"Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or catheter);","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0947","name":"Fracture frame attachmnts pe","description":"Fracture frame, attachments for complex pelvic traction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"34806","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"00164","name":"Anes px nose&sins bx sft tis","description":"Anesthesia for procedures on nose and accessory sinuses; biopsy, soft tissue","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4090","name":"Repl met band kafo-afo calf/","description":"Replace metal bands kafo-afo, calf or distal thigh","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"51784","name":"Anal/urinary muscle study","description":"Electromyography studies (emg) of anal or urethral sphincter, other than needle, any technique","date_of_service":"2026-05-10","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":"24925","name":"Amputation follow-up surgery","description":"Amputation, arm through humerus; secondary closure or scar revision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":652.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58956","name":"Bso omentectomy w/tah","description":"Bilateral salpingo-oophorectomy with total omentectomy, total abdominal hysterectomy for malignancy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73650","name":"X-ray exam of heel","description":"Radiologic examination; calcaneus, minimum of 2 views","date_of_service":"2026-05-10","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":"26675","name":"Treat hand dislocation","description":"Closed treatment of carpometacarpal dislocation, other than thumb, with manipulation, each joint; requiring anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"60520","name":"Removal of thymus gland","description":"Thymectomy, partial or total; transcervical approach (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":908.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70015","name":"Contrast x-ray of brain","description":"Cisternography, positive contrast, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76982","name":"Use 1st target lesion","description":"Ultrasound, elastography; first target lesion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33315","name":"Exploratory heart surgery","description":"Cardiotomy, exploratory (includes removal of foreign body, atrial or ventricular thrombus); with cardiopulmonary bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"31584","name":"Laryngoplasty fx rdctj fixj","description":"Laryngoplasty; with open reduction and fixation of (eg, plating) fracture, includes tracheostomy, if performed","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3187.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"93880","name":"Extracranial bilat study","description":"Duplex scan of extracranial arteries; complete bilateral study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0816","name":"Pwc gp 1 std cap chair","description":"Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1634.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":653.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"72275","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76800","name":"Us exam spinal canal","description":"Ultrasound, spinal canal and contents","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"61526","name":"Removal of brain lesion","description":"Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of cerebellopontine angle tumor;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27703","name":"Reconstruction ankle joint","description":"Arthroplasty, ankle; revision, total ankle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1359.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75705","name":"Artery x-rays spine","description":"Angiography, spinal, selective, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":779.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1595","name":"Injection glatiramer acetate","description":"Injection, glatiramer acetate, 20 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"23415","name":"Release of shoulder ligament","description":"Coracoacromial ligament release, with or without acromioplasty","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":587.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83716","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6550","name":"Neg pres wound ther drsg set","description":"Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories","date_of_service":"2026-05-10","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":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31575","name":"Diagnostic laryngoscopy","description":"Laryngoscopy, flexible; diagnostic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"93615","name":"Esophageal recording","description":"Esophageal recording of atrial electrogram with or without ventricular electrogram(s);","date_of_service":"2026-05-10","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":"87166","name":"Dark field exam w/o collj","description":"Dark field examination, any source (eg, penile, vaginal, oral, skin); without collection","date_of_service":"2026-05-10","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":"73085","name":"Contrast x-ray of elbow","description":"Radiologic examination, elbow, arthrography, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":941.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99218","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22849","name":"Reinsert spinal fixation","description":"Reinsertion of spinal fixation device","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88741","name":"Transcutaneous methb","description":"Hemoglobin, quantitative, transcutaneous, per day; methemoglobin","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57295","name":"Revise vag graft via vagina","description":"Revision (including removal) of prosthetic vaginal graft; vaginal approach","date_of_service":"2026-05-10","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":"00567","name":"Anes direct cabg w/pump","description":"Anesthesia for direct coronary artery bypass grafting; with pump oxygenator","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":465.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6694","name":"Elbow socket ins use w/lock","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism","date_of_service":"2026-05-10","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":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A9500","name":"Tc99m sestamibi","description":"Technetium tc-99m sestamibi, diagnostic, per study dose","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92556","name":"Speech audiometry complete","description":"Speech audiometry threshold; with speech recognition","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J3250","name":"Trimethobenzamide hcl inj","description":"Injection, trimethobenzamide hcl, up to 200 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54535","name":"Extensive testis surgery","description":"Orchiectomy, radical, for tumor; with abdominal exploration","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"24150","name":"Rad rescj tum dstl/shft hum","description":"Radical resection of tumor, shaft or distal humerus","date_of_service":"2026-05-10","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":"33764","name":"Shunt central w/prostc graft","description":"Shunt; central, with prosthetic graft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75996","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8641","name":"Metatarsal joint implant","description":"Metatarsal joint implant","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"88291","name":"Cyto/molecular report","description":"Cytogenetics and molecular cytogenetics, interpretation and report","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23650","name":"Cltx sho dslc w/mnpj wo anes","description":"Closed treatment of shoulder dislocation, with manipulation; without anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L7401","name":"Add ue prost a/e ultlite mat","description":"Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"00756","name":"Anes hrna rpr diphrg hrna","description":"Anesthesia for hernia repairs in upper abdomen; transabdominal repair of diaphragmatic hernia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"52001","name":"Cysto w/irrg&evac mlt clots","description":"Cystourethroscopy with irrigation and evacuation of multiple obstructing clots","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37231","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"25370","name":"Revise radius or ulna","description":"Multiple osteotomies, with realignment on intramedullary rod (sofield type procedure); radius or ulna","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":853.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1583.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"64640","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent; other peripheral nerve or branch","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77327","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2117.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42104","name":"Excision lesion mouth roof","description":"Excision, lesion of palate, uvula; without closure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45110","name":"Removal of rectum","description":"Proctectomy; complete, combined abdominoperineal, with colostomy","date_of_service":"2026-05-10","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":"60605","name":"Remove carotid body lesion","description":"Excision of carotid body tumor; with excision of carotid artery","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1325.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":599.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["AV","AU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"91055","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"56441","name":"Lysis of labial adhesions","description":"Lysis of labial adhesions","date_of_service":"2026-05-10","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":"65150","name":"Revise ocular implant","description":"Reinsertion of ocular implant; with or without conjunctival graft","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8694","name":"Aoi transducer/actuator repl","description":"Auditory osseointegrated device, transducer/actuator, replacement only, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"44346","name":"Revision of colostomy","description":"Revision of colostomy; with repair of paracolostomy hernia (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93979","name":"Vascular study","description":"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24155","name":"Resection of elbow joint","description":"Resection of elbow joint (arthrectomy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-10","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":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77762","name":"Apply intrcav radiat interm","description":"Intracavitary radiation source application; intermediate","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0467T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0012","name":"Ltwt portbl power whlchr","description":"Lightweight portable motorized/power wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2283.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6531","name":"Compress stking bk30-40 surg","description":"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["AW","GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0114","name":"Fern test","description":"Fern test","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","date_of_service":"2026-05-10","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":"47381","name":"Open ablate liver tumor cryo","description":"Ablation, open, of 1 or more liver tumor(s); cryosurgical","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"30020","name":"Drainage of nose lesion","description":"Drainage abscess or hematoma, nasal septum","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"42215","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate; major revision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":570.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"43888","name":"Gstr rstcv px opn rmvl&rplc","description":"Gastric restrictive procedure, open; removal and replacement of subcutaneous port component only","date_of_service":"2026-05-10","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":"27594","name":"Amputation follow-up surgery","description":"Amputation, thigh, through femur, any level; secondary closure or scar revision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0164","name":"Prochlorperazine maleate 5mg","description":"Prochlorperazine maleate, 5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6204","name":"Composite drsg >16<=48 sq in","description":"Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0469","name":"Tlso rig fram pelvic pre ots","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal and coronal ","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65730","name":"Corneal transplant","description":"Keratoplasty (corneal transplant); penetrating (except in aphakia or pseudophakia)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73700","name":"Ct lower extremity w/o dye","description":"Computed tomography, lower extremity; without contrast material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5781","name":"Lower limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01220","name":"Anes clsd px upper 2/3 femur","description":"Anesthesia for all closed procedures involving upper two-thirds of femur","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64570","name":"Remove vagus n eltrd","description":"Removal of cranial nerve (eg, vagus nerve) neurostimulator electrode array and pulse generator","date_of_service":"2026-05-10","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":"84163","name":"Pappa serum","description":"Pregnancy-associated plasma protein-a (papp-a)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59150","name":"Treat ectopic pregnancy","description":"Laparoscopic treatment of ectopic pregnancy; without salpingectomy and/or oophorectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":941.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43263","name":"Ercp sphincter pressure meas","description":"Endoscopic retrograde cholangiopancreatography (ercp); with pressure measurement of sphincter of oddi","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78205","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5712","name":"Knee-shin exo frict swg & st","description":"Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":780.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78740","name":"Ureteral reflux study","description":"Ureteral reflux study (radiopharmaceutical voiding cystogram)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76645","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1133.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"A6600","name":"G com bandge hgh dn foam sht","description":"Gradient compression bandaging supply, high density foam sheet, per 250 square centimeters, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01852","name":"Anes px vn f/arm phlbrrhaphy","description":"Anesthesia for procedures on veins of forearm, wrist, and hand; phleborrhaphy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"47125","name":"Partial removal of liver","description":"Hepatectomy, resection of liver; total left lobectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78191","name":"Platelet survival study","description":"Platelet survival study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","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":"J9290","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41145","name":"Tongue removal neck surgery","description":"Glossectomy; complete or total, with or without tracheostomy, with unilateral radical neck dissection","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"31781","name":"Reconstruct windpipe","description":"Excision tracheal stenosis and anastomosis; cervicothoracic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63740","name":"Install spinal shunt","description":"Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other; including laminectomy","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87470","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32005","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":669.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":352.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"77750","name":"Infuse radioactive materials","description":"Infusion or instillation of radioelement solution (includes 3-month follow-up care)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","date_of_service":"2026-05-10","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":"26471","name":"Fusion of finger tendons","description":"Tenodesis; of proximal interphalangeal joint, each joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1661.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2395.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78015","name":"Thyroid met imaging","description":"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5703","name":"Symes ankle w/o (sach) foot","description":"Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2755","name":"Carbon graphite lamination","description":"Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only","date_of_service":"2026-05-10","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":"32656","name":"Thoracoscopy w/pleurectomy","description":"Thoracoscopy, surgical; with parietal pleurectomy","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"60100","name":"Biopsy of thyroid","description":"Biopsy thyroid, percutaneous core needle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4322","name":"Irrigation syringe","description":"Irrigation syringe, bulb or piston, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1620","name":"Ho flex pavlik harns pre cst","description":"Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"A4651","name":"Calibrated microcap tube","description":"Calibrated microcapillary tube, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":797.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90682","name":"Riv4 vacc recombinant dna im","description":"Influenza virus vaccine, quadrivalent (riv4), derived from recombinant dna, hemagglutinin (ha) protein only, preservative and antibiotic free, for intramuscular use","date_of_service":"2026-05-10","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":73.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1229.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J2324","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1929.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"62292","name":"Njx chemonucleolysis lmbr","description":"Injection procedure for chemonucleolysis, including discography, intervertebral disc, single or multiple levels, lumbar","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21820","name":"Treat sternum fracture","description":"Closed treatment of sternum fracture","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1129.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":526.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"L6637","name":"Nudge control elbow lock","description":"Upper extremity addition, nudge control elbow lock","date_of_service":"2026-05-10","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":"83033","name":"Hemoglobin ftl f assay qual","description":"Hemoglobin; f (fetal), qualitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3900","name":"Hinge extension/flex wrist/f","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"47630","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1292.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"44383","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64575","name":"Opn impltj nea perph nerve","description":"Open implantation of neurostimulator electrode array; peripheral nerve (excludes sacral nerve)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":342.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78460","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2270","name":"Varus/valgus strap padded/li","description":"Addition to lower extremity, varus/valgus correction (t) strap, padded/lined or malleolus pad","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"47600","name":"Cholecystectomy","description":"Cholecystectomy;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4408","name":"Ext wear ost skn barr >4sqin","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5637","name":"Below knee total contact","description":"Addition to lower extremity, below knee, total contact","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"23700","name":"Mnpj anes sho jt fixj aprats","description":"Manipulation under anesthesia, shoulder joint, including application of fixation apparatus (dislocation excluded)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.64,"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63267","name":"Excise intrspinl lesion lmbr","description":"Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; lumbar","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"75960","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46936","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J9150","name":"Daunorubicin injection","description":"Injection, daunorubicin, 10 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67810","name":"Incal bx eyelid skn lid mrgn","description":"Incisional biopsy of eyelid skin including lid margin","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J7501","name":"Azathioprine parenteral","description":"Azathioprine, parenteral, 100 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1035.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75756","name":"Artery x-rays chest","description":"Angiography, internal mammary, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"28531","name":"Treat sesamoid bone fracture","description":"Open treatment of sesamoid fracture, with or without internal fixation","date_of_service":"2026-05-10","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":"L0482","name":"Tlso rigid lined custom fab","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90807","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00921","name":"Anes px male genitalia vasec","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); vasectomy, unilateral or bilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1002.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"01520","name":"Anes px veins lower leg nos","description":"Anesthesia for procedures on veins of lower leg; not otherwise specified","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50800","name":"Implant ureter in bowel","description":"Ureteroenterostomy, direct anastomosis of ureter to intestine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":973.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","date_of_service":"2026-05-10","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":"L0649","name":"Lso sc r pos/lat pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, clo","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2800","name":"Knee cap medial or lateral p","description":"Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"37203","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33207","name":"Insert heart pm ventricular","description":"Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); ventricular","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":587.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"32658","name":"Thoracoscopy w/sac fb remove","description":"Thoracoscopy, surgical; with removal of clot or foreign body from pericardial sac","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1853.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"84583","name":"Assay of urine urobilinogen","description":"Urobilinogen, urine; semiquantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1955","name":"Inj levocarnitine per 1 gm","description":"Injection, levocarnitine, per 1 gm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"J8540","name":"Oral dexamethasone","description":"Dexamethasone, oral, 0.25 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"B4164","name":"Parenteral 50% dextrose solu","description":"Parenteral nutrition solution: carbohydrates (dextrose), 50% or less (500 ml = 1 unit) - home mix","date_of_service":"2026-05-10","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":"88104","name":"Cytopath fl nongyn smears","description":"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1421.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"70360","name":"X-ray exam of neck","description":"Radiologic examination; neck, soft tissue","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"38200","name":"Injection for spleen x-ray","description":"Injection procedure for splenoportography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86327","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73000","name":"X-ray exam of collar bone","description":"Radiologic examination; clavicle, complete","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":837.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19367","name":"Brst rcnstj 1 pdcl tram flap","description":"Breast reconstruction; with single-pedicled transverse rectus abdominis myocutaneous (tram) flap","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28435","name":"Cltx talus fracture w/mnpj","description":"Closed treatment of talus fracture; with manipulation","date_of_service":"2026-05-10","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":"44143","name":"Partial removal of colon","description":"Colectomy, partial; with end colostomy and closure of distal segment (hartmann type procedure)","date_of_service":"2026-05-10","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":"00812","name":"Anes lwr intst scr colsc","description":"Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; screening colonoscopy","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5230","name":"Fem focal defic constant fri","description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1800","name":"Adjust elbow ext & flex dev","description":"Dynamic adjustable elbow extension and flexion device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"L7272","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"23156","name":"Removal of humerus lesion","description":"Excision or curettage of bone cyst or benign tumor of proximal humerus; with allograft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84150","name":"Assay of prostaglandin","description":"Prostaglandin, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2307","name":"Lens sphcy trifocal 4.25-7/.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"A4458","name":"Reusable enema bag","description":"Enema bag with tubing, reusable","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"75891","name":"Vein x-ray liver","description":"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1190","name":"Wheelchair amputee w/ leg re","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable elevating legrests","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81539","name":"Oncology prostate prob score","description":"Oncology (high-grade prostate cancer), biochemical assay of four proteins (total psa, free psa, intact psa, and human kallikrein-2 [hk2]), utilizing plasma or serum, prognostic algorithm reported as a probability score","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1596.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1854.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00820","name":"Anes px lwr post abdl wall","description":"Anesthesia for procedures on lower posterior abdominal wall","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"24940","name":"Revision of upper arm","description":"Cineplasty, upper extremity, complete procedure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L7401","name":"Add ue prost a/e ultlite mat","description":"Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77058","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0483","name":"Monitor elec vad, rep","description":"Monitor/display module for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2440","name":"Papaverin hcl injection","description":"Injection, papaverine hcl, up to 60 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27165","name":"Incision/fixation of femur","description":"Osteotomy, intertrochanteric or subtrochanteric including internal or external fixation and/or cast","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1545.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1572.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88125","name":"Forensic cytopathology","description":"Cytopathology, forensic (eg, sperm)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4411","name":"Ost skn barr extnd =4sq","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"73630","name":"X-ray exam of foot","description":"Radiologic examination, foot; complete, minimum of 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8613","name":"Ossicular implant","description":"Ossicula implant","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"A5507","name":"Modification diabetic shoe","description":"For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1469.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"76150","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3762","name":"Eo rigid w/o joints pre ots","description":"Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76930","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"87299","name":"Antibody detection nos if","description":"Infectious agent antigen detection by immunofluorescent technique; not otherwise specified, each organism","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71010","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32200","name":"Drain open lung lesion","description":"Pneumonostomy, with open drainage of abscess or cyst","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94010","name":"Breathing capacity test","description":"Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4432","name":"Os pch urine w bar/fange/tap","description":"Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":768.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":810.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69554","name":"Exc aurl glomus tum extended","description":"Excision aural glomus tumor; extended (extratemporal)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2980.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72074","name":"X-ray exam thorac spine4/>vw","description":"Radiologic examination, spine; thoracic, minimum of 4 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86325","name":"Other immunoelectrophoresis","description":"Immunoelectrophoresis; other fluids (eg, urine, cerebrospinal fluid) with concentration","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-10","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":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"92506","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":488.46,"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":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1394.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83001","name":"Assay of gonadotropin (fsh)","description":"Gonadotropin; follicle stimulating hormone (fsh)","date_of_service":"2026-05-10","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":"78456","name":"Acute venous thrombus image","description":"Acute venous thrombosis imaging, peptide","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82024","name":"Assay of acth","description":"Adrenocorticotropic hormone (acth)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2050","name":"Hkafo torsion cable hip pelv","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21034","name":"Excise max/zygoma mal tumor","description":"Excision of malignant tumor of maxilla or zygoma","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"76770","name":"Us exam abdo back wall comp","description":"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9230","name":"Mechlorethamine hcl inj","description":"Injection, mechlorethamine hydrochloride, (nitrogen mustard), 10 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"86361","name":"T cell absolute count","description":"T cells; absolute cd4 count","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"76496","name":"Unlisted fluoroscopic px","description":"Unlisted fluoroscopic procedure (eg, diagnostic, interventional)","date_of_service":"2026-05-10","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":"00754","name":"Anes hrna rpr omphalocele","description":"Anesthesia for hernia repairs in upper abdomen; omphalocele","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"27445","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"50125","name":"Pyelotomy w/drg pyelostomy","description":"Pyelotomy; with drainage, pyelostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":793.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74742","name":"X-ray fallopian tube","description":"Transcervical catheterization of fallopian tube, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31615","name":"Trcheobrnchsc est trachs inc","description":"Tracheobronchoscopy through established tracheostomy incision","date_of_service":"2026-05-10","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":"36100","name":"Establish access to artery","description":"Introduction of needle or intracatheter, carotid or vertebral artery","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36815","name":"Insertion of cannula","description":"Insertion of cannula for hemodialysis, other purpose (separate procedure); arteriovenous, external revision, or closure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76975","name":"Gi endoscopic ultrasound","description":"Gastrointestinal endoscopic ultrasound, supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27335","name":"Remove knee joint lining","description":"Arthrotomy, with synovectomy, knee; anterior and posterior including popliteal area","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31830","name":"Revise windpipe scar","description":"Revision of tracheostomy scar","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91040","name":"Esoph balloon distension tst","description":"Esophageal balloon distension study, diagnostic, with provocation when performed","date_of_service":"2026-05-10","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":"65780","name":"Ocular reconst transplant","description":"Ocular surface reconstruction; amniotic membrane transplantation, multiple layers","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33755","name":"Shunt as-aort to pulm art","description":"Shunt; ascending aorta to pulmonary artery (waterston type operation)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1514.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"00620","name":"Anes px thrc spine&cord nos","description":"Anesthesia for procedures on thoracic spine and cord, not otherwise specified","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":517.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"94350","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1867.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"74415","name":"Urography nfs drip&/bls w/nf","description":"Urography, infusion, drip technique and/or bolus technique; with nephrotomography","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"76950","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"85362","name":"Fibrin degradation products","description":"Fibrin(ogen) degradation (split) products (fdp) (fsp); agglutination slide, semiquantitative","date_of_service":"2026-05-10","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":"76998","name":"Us guide intraop","description":"Ultrasonic guidance, intraoperative","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0481","name":"Intrpulmnry percuss vent sys","description":"Intrapulmonary percussive ventilation system and related accessories","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49084","name":"Peritoneal lavage","description":"Peritoneal lavage, including imaging guidance, when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0012","name":"Ltwt portbl power whlchr","description":"Lightweight portable motorized/power wheelchair","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":549.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6235","name":"Hydrocolld drg >16<=48 w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"70355","name":"Panoramic x-ray of jaws","description":"Orthopantogram (eg, panoramic x-ray)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"91120","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37780","name":"Revision of leg vein","description":"Ligation and division of short saphenous vein at saphenopopliteal junction (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","date_of_service":"2026-05-10","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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88344","name":"Imhchem/imcytchm ea mlt antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44950","name":"Appendectomy","description":"Appendectomy;","date_of_service":"2026-05-10","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":"49041","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36860","name":"External cannula declotting","description":"External cannula declotting (separate procedure); without balloon catheter","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"L5614","name":"4-bar link above knee w/swng","description":"Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3486","name":"Ziprasidone mesylate","description":"Injection, ziprasidone mesylate, 10 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1624.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","22",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0494","name":"Emr hd pmp elec/combo, rep","description":"Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","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":"62145","name":"Repair of skull & brain","description":"Cranioplasty for skull defect with reparative brain surgery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1568.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43405","name":"Ligate/staple esophagus","description":"Ligation or stapling at gastroesophageal junction for pre-existing esophageal perforation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1448.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28304","name":"Incision of midfoot bones","description":"Osteotomy, tarsal bones, other than calcaneus or talus;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23420","name":"Repair of shoulder","description":"Reconstruction of complete shoulder (rotator) cuff avulsion, chronic (includes acromioplasty)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77295","name":"3-d radiotherapy plan","description":"3-dimensional radiotherapy plan, including dose-volume histograms","date_of_service":"2026-05-10","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":"77417","name":"Ther radiology port image(s)","description":"Therapeutic radiology port image(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"47383","name":"Perq abltj lvr cryoablation","description":"Ablation, 1 or more liver tumor(s), percutaneous, cryoablation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9033.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"24410","name":"Mlt osteot rlgnm imed rd hum","description":"Multiple osteotomies with realignment on intramedullary rod, humeral shaft (sofield type procedure)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61501","name":"Craniectomy f/osteomyelitis","description":"Craniectomy; for osteomyelitis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00522","name":"Anes clsd ch px ndl bx pleur","description":"Anesthesia for closed chest procedures; needle biopsy of pleura","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4367","name":"Ostomy belt","description":"Ostomy belt, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78761","name":"Testicular imaging w/flow","description":"Testicular imaging with vascular flow","date_of_service":"2026-05-10","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":"27535","name":"Treat knee fracture","description":"Open treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed","date_of_service":"2026-05-10","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":"31603","name":"Emer tracheostomy ttrach","description":"Tracheostomy, emergency procedure; transtracheal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":248.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72052","name":"X-ray exam neck spine 6/>vws","description":"Radiologic examination, spine, cervical; 6 or more views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"90792","name":"Psych diag eval w/med srvcs","description":"Psychiatric diagnostic evaluation with medical services","date_of_service":"2026-05-10","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":"52287","name":"Cystoscopy chemodenervation","description":"Cystourethroscopy, with injection(s) for chemodenervation of the bladder","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20972","name":"Bone/skin graft metatarsal","description":"Free osteocutaneous flap with microvascular anastomosis; metatarsal","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":817.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50630","name":"Removal of ureter stone","description":"Ureterolithotomy; lower one-third of ureter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"J3305","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28446","name":"Opn osteochondrl agrft talus","description":"Open osteochondral autograft, talus (includes obtaining graft[s])","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1197.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L2038","name":"Kafo w/o joint multi-axis an","description":"Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3652","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-05-10","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":"23620","name":"Cltx gr hmrl tbrs fx wo mnpj","description":"Closed treatment of greater humeral tuberosity fracture; without manipulation","date_of_service":"2026-05-10","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":"94660","name":"Cpap initiation&mgmt","description":"Continuous positive airway pressure ventilation (cpap), initiation and management","date_of_service":"2026-05-10","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":"J1840","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0610","name":"Pacemaker monitr audible/vis","description":"Pacemaker monitor, self-contained, (checks battery depletion, includes audible and visible check systems)","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"90826","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75970","name":"Vascular biopsy","description":"Transcatheter biopsy, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"80186","name":"Assay of phenytoin free","description":"Phenytoin; free","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"92070","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","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":"26560","name":"Repair of web finger","description":"Repair of syndactyly (web finger) each web space; with skin flaps","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0455","name":"Pump uninterrupted infusion","description":"Infusion pump used for uninterrupted parenteral administration of medication, (e.g., epoprostenol or treprostinol)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0250","name":"Hosp bed fixed ht w/ mattres","description":"Hospital bed, fixed height, with any type side rails, with mattress","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01490","name":"Anes lwr leg cst app rmv/rpr","description":"Anesthesia for lower leg cast application, removal, or repair","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2303","name":"Lens sphcy trifocal 4.0/.12-","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"0209T","name":"Audiometry air & bone","description":"Pure tone audiometry (threshold), automated; air and bone","date_of_service":"2026-05-10","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":"50340","name":"Recipient nephrectomy","description":"Recipient nephrectomy (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1405","name":"O2/water vapor enrich w/heat","description":"Oxygen and water vapor enriching system with heated delivery","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"35184","name":"Rpr cgen av fistula xtr","description":"Repair, congenital arteriovenous fistula; extremities","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"L3671","name":"So cap design w/o jnts cf","description":"Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8680","name":"Implt neurostim elctr each","description":"Implantable neurostimulator electrode, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20663","name":"Application halo femoral","description":"Application of halo, including removal; femoral","date_of_service":"2026-05-10","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":"72010","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77065","name":"Dx mammo incl cad uni","description":"Diagnostic mammography, including computer-aided detection (cad) when performed; unilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1672.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42972","name":"Control nose/throat bleeding","description":"Control of nasopharyngeal hemorrhage, primary or secondary (eg, postadenoidectomy); with secondary surgical intervention","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92603","name":"Cochlear implt f/up exam 7/>","description":"Diagnostic analysis of cochlear implant, age 7 years or older; with programming","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19271","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92145","name":"Corneal hysteresis deter","description":"Corneal hysteresis determination, by air impulse stimulation, unilateral or bilateral, with interpretation and report","date_of_service":"2026-05-10","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":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58520","name":"Repair of ruptured uterus","description":"Hysterorrhaphy, repair of ruptured uterus (nonobstetrical)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75805","name":"Lymph vessel x-ray trunk","description":"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"99177","name":"Ocular instrumnt screen bil","description":"Instrument-based ocular screening (eg, photoscreening, automated-refraction), bilateral; with on-site analysis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"19103","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5210","name":"No knee/ankle joints w/ ft b","description":"Above knee, short prosthesis, no knee joint (stubbies), with foot blocks, no ankle joints, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"46715","name":"Rep perf anoper fistu","description":"Repair of low imperforate anus; with anoperineal fistula (cut-back procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3760","name":"Eo adj jt prefab custom fit","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific  patient by an individual with expertise","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"68320","name":"Revise/graft eyelid lining","description":"Conjunctivoplasty; with conjunctival graft or extensive rearrangement","date_of_service":"2026-05-10","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":"78216","name":"Lvr&spleen img w/vasc flow","description":"Liver and spleen imaging; with vascular flow","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L3350","name":"Shoe heel wedge","description":"Heel wedge","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"96402","name":"Chemo hormon antineopl sq/im","description":"Chemotherapy administration, subcutaneous or intramuscular; hormonal anti-neoplastic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77072","name":"Bone age studies","description":"Bone age studies","date_of_service":"2026-05-10","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":"95829","name":"Surgery electrocorticogram","description":"Electrocorticogram at surgery (separate procedure)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69140","name":"Remove ear canal lesion(s)","description":"Excision exostosis(es), external auditory canal","date_of_service":"2026-05-10","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":"60212","name":"Partial thyroid excision","description":"Partial thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":897.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65775","name":"Correction of astigmatism","description":"Corneal wedge resection for correction of surgically induced astigmatism","date_of_service":"2026-05-10","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":"95812","name":"Eeg 41-60 minutes","description":"Electroencephalogram (eeg) extended monitoring; 41-60 minutes","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":345.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","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":"2026-05-10","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":"L3966","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":774.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78230","name":"Salivary gland imaging","description":"Salivary gland imaging;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95908","name":"Nrv cndj tst 3-4 studies","description":"Nerve conduction studies; 3-4 studies","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"97028","name":"Ultraviolet therapy","description":"Application of a modality to 1 or more areas; ultraviolet","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"B9002","name":"Enter nutr inf pump any type","description":"Enteral nutrition infusion pump, any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1860","name":"Ko supracondylar socket mold","description":"Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55400","name":"Repair of sperm duct","description":"Vasovasostomy, vasovasorrhaphy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1315.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"38230","name":"Bone marrow harvest allogen","description":"Bone marrow harvesting for transplantation; allogeneic","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":655.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62146","name":"Crnop w/autograft<5 cm diam","description":"Cranioplasty with autograft (includes obtaining bone grafts); up to 5 cm diameter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1346.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"55500","name":"Removal of hydrocele","description":"Excision of hydrocele of spermatic cord, unilateral (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93556","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"50525","name":"Close nephrovisceral fistula","description":"Closure of nephrovisceral fistula (eg, renocolic), including visceral repair; abdominal approach","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6642","name":"Excursion amplifier lever ty","description":"Upper extremity addition, excursion amplifier, lever type","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","date_of_service":"2026-05-10","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":"35311","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; subclavian, innominate, by thoracic incision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1874.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"70200","name":"X-ray exam of eye sockets","description":"Radiologic examination; orbits, complete, minimum of 4 views","date_of_service":"2026-05-10","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":"43239","name":"Egd biopsy single/multiple","description":"Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0197","name":"Air pressure pad for mattres","description":"Air pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"93315","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31084","name":"Removal of frontal sinus","description":"Sinusotomy frontal; obliterative, with osteoplastic flap, brow incision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93965","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0456","name":"Tlso flex trnk sj-ss pre cst","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L3595","name":"Ortho shoe add march bar","description":"Orthopedic shoe addition, march bar","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":428.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72170","name":"X-ray exam of pelvis","description":"Radiologic examination, pelvis; 1 or 2 views","date_of_service":"2026-05-10","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":"20251","name":"Biopsy vrt bdy open lmbr/crv","description":"Biopsy, vertebral body, open; lumbar or cervical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":374.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-10","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":"68840","name":"Explore/irrigate tear ducts","description":"Probing of lacrimal canaliculi, with or without irrigation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"77418","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75964","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"86806","name":"Lymphocytotoxicity assay","description":"Lymphocytotoxicity assay, visual crossmatch; without titration","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9015","name":"Aldesleukin injection","description":"Injection, aldesleukin, per single use vial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":672.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2103","name":"Spherocylindr 4.00d/12-2.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82131","name":"Amino acids single quant","description":"Amino acids; single, quantitative, each specimen","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"96150","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45123","name":"Partial proctectomy","description":"Proctectomy, partial, without anastomosis, perineal approach","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1975.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1953.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61581","name":"Craniofacial approach skull","description":"Craniofacial approach to anterior cranial fossa; extradural, including lateral rhinotomy, orbital exenteration, ethmoidectomy, sphenoidectomy and/or maxillectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3965","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"95065","name":"Dir nsl mucous membrane test","description":"Direct nasal mucous membrane test","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6975","name":"Interscap-thor myoelectronic","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-10","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":"33273","name":"Repos prev impltbl subq dfb","description":"Repositioning of previously implanted subcutaneous implantable defibrillator electrode","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":465.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"43415","name":"Repair esophagus wound","description":"Suture of esophageal wound or injury; transthoracic or transabdominal approach","date_of_service":"2026-05-10","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":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-05-10","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":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","date_of_service":"2026-05-10","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":"24147","name":"Prtl exc bone olecrn process","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), olecranon process","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1225.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72195","name":"Mri pelvis w/o dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90853","name":"Group psychotherapy","description":"Group psychotherapy (other than of a multiple-family group)","date_of_service":"2026-05-10","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":"L6386","name":"Postop ea cast chg & realign","description":"Immediate post surgical or early fitting, each additional cast change and realignment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4387","name":"Ost clsd pouch w att st barr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"43246","name":"Egd place gastrostomy tube","description":"Esophagogastroduodenoscopy, flexible, transoral; with directed placement of percutaneous gastrostomy tube","date_of_service":"2026-05-10","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":"E0200","name":"Heat lamp without stand","description":"Heat lamp, without stand (table model), includes bulb, or infrared element","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24354","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":627.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q4019","name":"Cast sup lng arm splnt ped p","description":"Cast supplies, long arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L3520","name":"O shoe add felt w leath insl","description":"Orthopedic shoe addition, insole, felt covered with leather","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"83866","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"97799","name":"Unlisted physcl med/rehab px","description":"Unlisted physical medicine/rehabilitation service or procedure","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1640","name":"Pelv band/spread bar thigh c","description":"Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1877.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"55450","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":273.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84080","name":"Assay alkaline phosphatases","description":"Phosphatase, alkaline; isoenzymes","date_of_service":"2026-05-10","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":"J0150","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"93451","name":"Right heart cath","description":"Right heart catheterization including measurement(s) of oxygen saturation and cardiac output, when performed","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"37228","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76062","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"01140","name":"Anes ntrplvabdmnl amputation","description":"Anesthesia for interpelviabdominal (hindquarter) amputation","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":821.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38206","name":"Harvest auto stem cells","description":"Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; autologous","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81190","name":"Cstb gene known famil vrnt","description":"Cstb (cystatin b) (eg, unverricht-lundborg disease) gene analysis; known familial variant(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26034","name":"Treat hand bone lesion","description":"Incision, bone cortex, hand or finger (eg, osteomyelitis or bone abscess)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A7504","name":"Tracheostoma hmes filter","description":"Filter for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-10","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":"E1160","name":"Wheelchair fixed arms","description":"Wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Electro pump enema, reusable","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6016","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"86355","name":"B cells total count","description":"B cells, total count","date_of_service":"2026-05-10","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":"15820","name":"Blepharoplasty lower eyelid","description":"Blepharoplasty, lower eyelid;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"21060","name":"Remove jaw joint cartilage","description":"Meniscectomy, partial or complete, temporomandibular joint (separate procedure)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":938.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":310.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26035","name":"Decompress fingers/hand","description":"Decompression fingers and/or hand, injection injury (eg, grease gun)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":855.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55605","name":"Vesiculotomy complicated","description":"Vesiculotomy; complicated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","date_of_service":"2026-05-10","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":"A6596","name":"G comp bandge conform gauze","description":"Gradient compression bandaging supply, conforming gauze, per linear yard, any width, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":725.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88380","name":"Microdissection laser","description":"Microdissection (ie, sample preparation of microscopically identified target); laser capture","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"82626","name":"Dehydroepiandrosterone","description":"Dehydroepiandrosterone (dhea)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"36625","name":"Insertion catheter artery","description":"Arterial catheterization or cannulation for sampling, monitoring or transfusion (separate procedure); cutdown","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75961","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6676","name":"Harness figure of 8 dual con","description":"Upper extremity addition, harness, (e.g., figure of eight type), dual cable design","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"31587","name":"Laryngoplasty cricoid split","description":"Laryngoplasty, cricoid split, without graft placement","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":807.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75940","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-10","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":"B9004","name":"Parenteral infus pump portab","description":"Parenteral nutrition infusion pump, portable","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"78206","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20670","name":"Removal implant superficial","description":"Removal of implant; superficial (eg, buried wire, pin or rod) (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1416.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64714","name":"Revise low back nerve(s)","description":"Neuroplasty, major peripheral nerve, arm or leg, open; lumbar plexus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"31766","name":"Carinal reconstruction","description":"Carinal reconstruction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E1172","name":"Wheelchair amputee detach ar","description":"Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1552.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"E0983","name":"Add pwr joystick","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, joystick control","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"00802","name":"Anes px lwr abdl wal pannic","description":"Anesthesia for procedures on lower anterior abdominal wall; panniculectomy","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"51920","name":"Close bladder-uterus fistula","description":"Closure of vesicouterine fistula;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":823.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93041","name":"Rhythm ecg tracing","description":"Rhythm ecg, 1-3 leads; tracing only without interpretation and report","date_of_service":"2026-05-10","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":"15171","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["AU"]}],"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":"2026-05-10","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":"E0460","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83663","name":"Fluoro polarize fetal lung","description":"Fetal lung maturity assessment; fluorescence polarization","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"90817","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4641","name":"Radiopharm dx agent noc","description":"Radiopharmaceutical, diagnostic, not otherwise classified","date_of_service":"2026-05-10","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":"77059","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44314","name":"Revision of ileostomy","description":"Revision of ileostomy; complicated (reconstruction in-depth) (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99174","name":"Ocular instrumnt screen bil","description":"Instrument-based ocular screening (eg, photoscreening, automated-refraction), bilateral; with remote analysis and report","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-10","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":"64776","name":"Remove digit nerve lesion","description":"Excision of neuroma; digital nerve, 1 or both, same digit","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"93603","name":"Right ventricular recording","description":"Right ventricular recording","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0433","name":"Portable liquid oxygen sys","description":"Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2069.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J7341","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76819","name":"Fetal biophys profil w/o nst","description":"Fetal biophysical profile; without non-stress testing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72070","name":"X-ray exam thorac spine 2vws","description":"Radiologic examination, spine; thoracic, 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6554","name":"Grad com stocking bk 40+","description":"Gradient compression stocking, below knee, 40 mmhg or greater, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"95937","name":"Neuromuscular junction test","description":"Neuromuscular junction testing (repetitive stimulation, paired stimuli), each nerve, any 1 method","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68400","name":"I&d lacrimal gland","description":"Incision, drainage of lacrimal gland","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43285","name":"Rmvl esophgl sphnctr dev","description":"Removal of esophageal sphincter augmentation device","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35860","name":"Explore limb vessels","description":"Exploration for postoperative hemorrhage, thrombosis or infection; extremity","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":467.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","date_of_service":"2026-05-10","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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","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":"2026-05-10","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":"L3255","name":"Orth foot non-standard size/","description":"Non-standard size or length","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00212","name":"Anes icr px subdural taps","description":"Anesthesia for intracranial procedures; subdural taps","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":"78264","name":"Gastric emptying img study","description":"Gastric emptying imaging study (eg, solid, liquid, or both);","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"3080F","name":"Diast bp >= 90 mm hg","description":"Most recent diastolic blood pressure greater than or equal to 90 mm hg (htn, ckd, cad) (dm)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0639","name":"Lso s/c shell/panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1812","name":"Knee ext/flex w act res ctrl","description":"Dynamic knee, extension/flexion device with active resistance control","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"36513","name":"Apheresis platelets","description":"Therapeutic apheresis; for platelets","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"15830","name":"Exc excessive skin abdomen","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); abdomen, infraumbilical panniculectomy","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3674","name":"So airplane w/wo joint cf","description":"Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38542","name":"Explore deep node(s) neck","description":"Dissection, deep jugular node(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":493.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"72220","name":"X-ray exam sacrum tailbone","description":"Radiologic examination, sacrum and coccyx, minimum of 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"67916","name":"Repair eyelid defect","description":"Repair of ectropion; excision tarsal wedge","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44050","name":"Reduce bowel obstruction","description":"Reduction of volvulus, intussusception, internal hernia, by laparotomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-10","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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-10","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":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20205","name":"Deep muscle biopsy","description":"Biopsy, muscle; deep","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26852","name":"Fusion of knuckle with graft","description":"Arthrodesis, metacarpophalangeal joint, with or without internal fixation; with autograft (includes obtaining graft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1039.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"27405","name":"Repair of knee ligament","description":"Repair, primary, torn ligament and/or capsule, knee; collateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"86738","name":"Mycoplasma antibody","description":"Antibody; mycoplasma","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83008","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63273","name":"Excise intrspinl lesion scrl","description":"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; sacral","date_of_service":"2026-05-10","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":"0298T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"54865","name":"Explore epididymis","description":"Exploration of epididymis, with or without biopsy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64856","name":"Repair/transpose nerve","description":"Suture of major peripheral nerve, arm or leg, except sciatic; including transposition","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1995.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2035","name":"Kafo plastic pediatric size","description":"Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":"21740","name":"Reconstruction of sternum","description":"Reconstructive repair of pectus excavatum or carinatum; open","date_of_service":"2026-05-10","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":"00537","name":"Anes cardiac ep procedures","description":"Anesthesia for cardiac electrophysiologic procedures including radiofrequency ablation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"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":"A6211","name":"Foam drg > 48 sq in w/o brdr","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"87273","name":"Herpes simplex 2 ag if","description":"Infectious agent antigen detection by immunofluorescent technique; herpes simplex virus type 2","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"92354","name":"Fitg spect low vis 1system","description":"Fitting of spectacle mounted low vision aid; single element system","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A6210","name":"Foam drg >16<=48 sq in w/o b","description":"Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"A4393","name":"Urine pch w ex wear bar conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23170","name":"Sequestrectomy clavicle","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), clavicle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":635.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1152.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72125","name":"Ct neck spine w/o dye","description":"Computed tomography, cervical spine; without contrast material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74420","name":"Urography rtrgr +-kub","description":"Urography, retrograde, with or without kub","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3807","name":"Whfo w/o joints pre cst","description":"Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","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":"69401","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"76880","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6635","name":"Lift assist for elbow","description":"Upper extremity addition, lift assist for elbow","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"J9140","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35521","name":"Art byp grft axill-femoral","description":"Bypass graft, with vein; axillary-femoral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42260","name":"Repair nose to lip fistula","description":"Repair of nasolabial fistula","date_of_service":"2026-05-10","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":"A6402","name":"Sterile gauze <= 16 sq in","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":786.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":765.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-10","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":"53621","name":"Dilate urethra stricture","description":"Dilation of urethral stricture by passage of filiform and follower, male; subsequent","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67840","name":"Remove eyelid lesion","description":"Excision of lesion of eyelid (except chalazion) without closure or with simple direct closure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75805","name":"Lymph vessel x-ray trunk","description":"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4371","name":"Skin barrier powder per oz","description":"Ostomy skin barrier, powder, per oz","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","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":"75958","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"A4316","name":"Cath w/drainage 3-way","description":"Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"60500","name":"Explore parathyroid glands","description":"Parathyroidectomy or exploration of parathyroid(s);","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"93511","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2219.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q4043","name":"Cast sup lng leg splnt ped p","description":"Cast supplies, long leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15001","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4222","name":"Infusion supplies with pump","description":"Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately)","date_of_service":"2026-05-10","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":"28300","name":"Incision of heel bone","description":"Osteotomy; calcaneus (eg, dwyer or chambers type procedure), with or without internal fixation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":823.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1949.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KM"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KF"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":635.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35206","name":"Repair blood vessel dir uxtr","description":"Repair blood vessel, direct; upper extremity","date_of_service":"2026-05-10","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":"77053","name":"X-ray of mammary duct","description":"Mammary ductogram or galactogram, single duct, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"97003","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73092","name":"X-ray exam of arm infant","description":"Radiologic examination; upper extremity, infant, minimum of 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78261","name":"Gastric mucosa imaging","description":"Gastric mucosa imaging","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76071","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-10","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":"61520","name":"Removal of brain lesion","description":"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; cerebellopontine angle tumor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4379.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92544","name":"Optokinetic nystagmus test","description":"Optokinetic nystagmus test, bidirectional, foveal or peripheral stimulation, with recording","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57100","name":"Biopsy vaginal mucosa simple","description":"Biopsy of vaginal mucosa; simple (separate procedure)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64425","name":"Njx aa&/strd ii ih nerves","description":"Injection(s), anesthetic agent(s) and/or steroid; ilioinguinal, iliohypogastric nerves","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"B4104","name":"Additive for enteral formula","description":"Additive for enteral formula (e.g., fiber)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83634","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82671","name":"Assay of estrogens","description":"Estrogens; fractionated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93980","name":"Penile vascular study","description":"Duplex scan of arterial inflow and venous outflow of penile vessels; complete study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01622","name":"Anes dx arthr px shoulder jt","description":"Anesthesia for diagnostic arthroscopic procedures of shoulder joint","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6541","name":"Gc stocking waistlngth 40+","description":"Gradient compression stocking, waist length, 40 mmhg or greater, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"37204","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":957.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"49040","name":"Drain open abdom abscess","description":"Drainage of subdiaphragmatic or subphrenic abscess, open","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"01960","name":"Anes vaginal delivery only","description":"Anesthesia for vaginal delivery only","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6714","name":"Ped term dev, hand, vol clos","description":"Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8621","name":"Repl zinc air battery","description":"Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42145","name":"Repair palate pharynx/uvula","description":"Palatopharyngoplasty (eg, uvulopalatopharyngoplasty, uvulopharyngoplasty)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":726.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2384.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"90380","name":"Rsv monoc antb seasn .5ml im","description":"Respiratory syncytial virus, monoclonal antibody, seasonal dose; 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","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":678.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"42120","name":"Remove palate/lesion","description":"Resection of palate or extensive resection of lesion","date_of_service":"2026-05-10","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":"33238","name":"Remove electrode/thoracotomy","description":"Removal of permanent transvenous electrode(s) by thoracotomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1135.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"01756","name":"Anes opn/arthrs elbw rad px","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; radical procedures","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0779","name":"Amb infusion pump mechanical","description":"Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59001","name":"Amniocentesis therapeutic","description":"Amniocentesis; therapeutic amniotic fluid reduction (includes ultrasound guidance)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80195","name":"Assay of sirolimus","description":"Sirolimus","date_of_service":"2026-05-10","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":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L7274","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3115.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0376","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90805","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"55720","name":"Drainage of prostate abscess","description":"Prostatotomy, external drainage of prostatic abscess, any approach; simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1556.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76641","name":"Ultrasound breast complete","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["TC"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1649.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01464","name":"Anes arthrs px ankle&/foot","description":"Anesthesia for arthroscopic procedures of ankle and/or foot","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57230","name":"Repair of urethral lesion","description":"Plastic repair of urethrocele","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92572","name":"Staggered spondaic word test","description":"Staggered spondaic word test","date_of_service":"2026-05-10","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":"27486","name":"Revise/replace knee joint","description":"Revision of total knee arthroplasty, with or without allograft; 1 component","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1644.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1046.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"46705","name":"Repair of anal stricture","description":"Anoplasty, plastic operation for stricture; infant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":514.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":897.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93539","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27487","name":"Revise/replace knee joint","description":"Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0491","name":"Tlso 2 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the ","date_of_service":"2026-05-10","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":"Q4007","name":"Cast sup long arm ped plster","description":"Cast supplies, long arm cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1799.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78006","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"A6455","name":"Self-adher band >=5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":625.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92996","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25628","name":"Optx carpl scphd fx int fixj","description":"Open treatment of carpal scaphoid (navicular) fracture, includes internal fixation, when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25449","name":"Revj arthrp wrist joint","description":"Revision of arthroplasty, including removal of implant, wrist joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1240.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KC"]}],"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":"2026-05-10","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":"L1932","name":"Afo rig ant tib tcf/= custom","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25290","name":"Incise wrist/forearm tendon","description":"Tenotomy, open, flexor or extensor tendon, forearm and/or wrist, single, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":986.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A6224","name":"Gauze > 48 in no w/sal w/o b","description":"Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-10","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":"43245","name":"Egd dilate stricture","description":"Esophagogastroduodenoscopy, flexible, transoral; with dilation of gastric/duodenal stricture(s) (eg, balloon, bougie)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40701","name":"Repair cleft lip/nasal","description":"Plastic repair of cleft lip/nasal deformity; primary bilateral, 1-stage procedure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1290.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82670","name":"Assay of total estradiol","description":"Estradiol; total","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31239","name":"Nsl/sinus endoscopy surg dcr","description":"Nasal/sinus endoscopy, surgical; with dacryocystorhinostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":774.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4612","name":"Battery cables","description":"Battery cables; replacement for patient-owned ventilator","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74018","name":"Radex abdomen 1 view","description":"Radiologic examination, abdomen; 1 view","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"23101","name":"Arthrt acrmclv/strnclav jt","description":"Arthrotomy, acromioclavicular joint or sternoclavicular joint, including biopsy and/or excision of torn cartilage","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70553","name":"Mri brain stem w/o & w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88154","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67208","name":"Treatment of retinal lesion","description":"Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; cryotherapy, diathermy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":471.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74021","name":"Radex abdomen 3+ views","description":"Radiologic examination, abdomen; 3 or more views","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":740.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"15732","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1434.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"77427","name":"Radiation tx management x5","description":"Radiation treatment management, 5 treatments","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67505","name":"Inject/treat eye socket","description":"Retrobulbar injection; alcohol","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4930","name":"Sterile, gloves per pair","description":"Gloves, sterile, per pair","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":532.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68850","name":"Injection for tear sac x-ray","description":"Injection of contrast medium for dacryocystography","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","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":"82495","name":"Assay of chromium","description":"Chromium","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1810","name":"Ko elastic with joints","description":"Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","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":"84155","name":"Assay of protein serum","description":"Protein, total, except by refractometry; serum, plasma or whole blood","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"35905","name":"Excision graft thorax","description":"Excision of infected graft; thorax","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1553.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40805","name":"Removal foreign body mouth","description":"Removal of embedded foreign body, vestibule of mouth; complicated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"36515","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43220","name":"Esophagoscopy balloon <30mm","description":"Esophagoscopy, flexible, transoral; with transendoscopic balloon dilation (less than 30 mm diameter)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"92512","name":"Nasal function studies","description":"Nasal function studies (eg, rhinomanometry)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87230","name":"Toxin/antitoxin asy tiss cul","description":"Toxin or antitoxin assay, tissue culture (eg, clostridium difficile toxin)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","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":"25085","name":"Incision of wrist capsule","description":"Capsulotomy, wrist (eg, contracture)","date_of_service":"2026-05-10","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":"27003","name":"Tnot adductr subq opn neurct","description":"Tenotomy, adductor, subcutaneous, open, with obturator neurectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1867.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"36515","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2105","name":"Spherocylinder 4.00d/4.25-6d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88280","name":"Chromosome karyotype study","description":"Chromosome analysis; additional karyotypes, each study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4413","name":"2 pc drainable ost pouch","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":940.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0180","name":"Dolasetron mesylate oral","description":"Dolasetron mesylate, 100 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 24 hour dosage regimen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4396","name":"Static or dynami afo pre cst","description":"Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75970","name":"Vascular biopsy","description":"Transcatheter biopsy, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"25907","name":"Amputation follow-up surgery","description":"Amputation, forearm, through radius and ulna; secondary closure or scar revision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":517.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93744","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"60600","name":"Remove carotid body lesion","description":"Excision of carotid body tumor; without excision of carotid artery","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"92545","name":"Oscillating tracking test","description":"Oscillating tracking test, with recording","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"37600","name":"Ligation xtrnl carotid art","description":"Ligation; external carotid artery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-10","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":"L3252","name":"Shoe molded plastazote cust","description":"Foot, shoe molded to patient model, plastazote (or similar), custom fabricated, each","date_of_service":"2026-05-10","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":"J8600","name":"Melphalan oral 2 mg","description":"Melphalan; oral, 2 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33403","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"00844","name":"Anes iper px abdmnprnl rescj","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; abdominoperineal resection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6581","name":"Gradient comp glove","description":"Gradient compression glove, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"K0009","name":"Other manual wheelchair/base","description":"Other manual wheelchair/base","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11300","name":"Shave skin lesion 0.5 cm/<","description":"Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion diameter 0.5 cm or less","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64784","name":"Remove nerve lesion","description":"Excision of neuroma; major peripheral nerve, except sciatic","date_of_service":"2026-05-10","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":"24600","name":"Tx clsd elbow dislc w/o anes","description":"Treatment of closed elbow dislocation; without anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1335","name":"Ertapenem injection","description":"Injection, ertapenem sodium, 500 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"99441","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2037","name":"Kafo plas sing free knee mol","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01860","name":"Anes forearm wrist/hand cast","description":"Anesthesia for forearm, wrist, or hand cast application, removal, or repair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"61796","name":"Srs cranial lesion simple","description":"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 simple cranial lesion","date_of_service":"2026-05-10","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":"33206","name":"Insert heart pm atrial","description":"Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L0466","name":"Tlso r fram soft ant pre cst","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled,","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"54111","name":"Treat penis lesion graft","description":"Excision of penile plaque (peyronie disease); with graft to 5 cm in length","date_of_service":"2026-05-10","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":"L2425","name":"Knee disc/dial lock/adj flex","description":"Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1153.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93982","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"92518","name":"Vemp test i&r ocular","description":"Vestibular evoked myogenic potential (vemp) testing, with interpretation and report; ocular (ovemp)","date_of_service":"2026-05-10","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":"A6595","name":"G comp bandge liner upr extr","description":"Gradient compression bandaging supply, bandage liner, upper extremity, any size or length, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"86658","name":"Enterovirus antibody","description":"Antibody; enterovirus (eg, coxsackie, echo, polio)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"69706","name":"Nps surg dilat eust tube bi","description":"Nasopharyngoscopy, surgical, with dilation of eustachian tube (ie, balloon dilation); bilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21248","name":"Reconstruction of jaw","description":"Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); partial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"49080","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"Q4079","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"26820","name":"Thumb fusion with graft","description":"Fusion in opposition, thumb, with autogenous graft (includes obtaining graft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1052.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"88262","name":"Chromosome analysis 15-20","description":"Chromosome analysis; count 15-20 cells, 2 karyotypes, with banding","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"93529","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2776.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"83021","name":"Hemoglobin chromotography","description":"Hemoglobin fractionation and quantitation; chromatography (eg, a2, s, c, and/or f)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0434","name":"Portable liquid 02","description":"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing","date_of_service":"2026-05-10","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":"50544","name":"Laparoscopy pyeloplasty","description":"Laparoscopy, surgical; pyeloplasty","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67917","name":"Repair eyelid defect","description":"Repair of ectropion; extensive (eg, tarsal strip operations)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2502.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"43195","name":"Esophagoscopy rigid balloon","description":"Esophagoscopy, rigid, transoral; with balloon dilation (less than 30 mm diameter)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0744","name":"Neuromuscular stim for scoli","description":"Neuromuscular stimulator for scoliosis","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1197.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L1085","name":"Outrigger bil w/ vert extens","description":"Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76641","name":"Ultrasound breast complete","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0681","name":"Non pneu comp control w/o ca","description":"Non-pneumatic compression controller without calibrated gradient pressure","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L0462","name":"Tlso 3mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"52647","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":682.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1231.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87280","name":"Respiratory syncytial ag if","description":"Infectious agent antigen detection by immunofluorescent technique; respiratory syncytial virus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25215","name":"Removal of wrist bones","description":"Carpectomy; all bones of proximal row","date_of_service":"2026-05-10","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":"73040","name":"Contrast x-ray of shoulder","description":"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61156","name":"Burr hol aspir hmtm/cst icer","description":"Burr hole(s); with aspiration of hematoma or cyst, intracerebral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"82374","name":"Assay blood carbon dioxide","description":"Carbon dioxide (bicarbonate)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"P9021","name":"Red blood cells unit","description":"Red blood cells, each unit","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":488.46,"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":"74185","name":"Mra abd w or w/o cntrst","description":"Magnetic resonance angiography, abdomen, with or without contrast material(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33472","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1364.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34510","name":"Transposition of vein valve","description":"Venous valve transposition, any vein donor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1365.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":607.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88150","name":"Cytopath c/v manual","description":"Cytopathology, slides, cervical or vaginal; manual screening under physician supervision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":941.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3978","name":"Sewhfo airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"89135","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"3078F","name":"Diast bp <80 mm hg","description":"Most recent diastolic blood pressure less than 80 mm hg (htn, ckd, cad) (dm)","date_of_service":"2026-05-10","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":2.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3904","name":"Whfo electric custom fitted","description":"Wrist hand finger orthosis, external powered, electric, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"20561","name":"Ndl insj w/o njx 3+ musc","description":"Needle insertion(s) without injection(s); 3 or more muscles","date_of_service":"2026-05-10","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":"85379","name":"Fibrin degradation quant","description":"Fibrin degradation products, d-dimer; quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8600","name":"Implant breast silicone/eq","description":"Implantable breast prosthesis, silicone or equal","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"49021","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4430","name":"Ost urine pch w b/bltin conv","description":"Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-10","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":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-10","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":"35201","name":"Repair blood vessel dir neck","description":"Repair blood vessel, direct; neck","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1183.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76817","name":"Transvaginal us obstetric","description":"Ultrasound, pregnant uterus, real time with image documentation, transvaginal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0002A","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"45900","name":"Reduction of rectal prolapse","description":"Reduction of procidentia (separate procedure) under anesthesia","date_of_service":"2026-05-10","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":"90839","name":"Psytx crisis initial 60 min","description":"Psychotherapy for crisis; first 60 minutes","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G6024","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":"27392","name":"Incision of thigh tendons","description":"Tenotomy, open, hamstring, knee to hip; multiple tendons, bilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":689.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"43254","name":"Egd endo mucosal resection","description":"Esophagogastroduodenoscopy, flexible, transoral; with endoscopic mucosal resection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"40810","name":"Excision of mouth lesion","description":"Excision of lesion of mucosa and submucosa, vestibule of mouth; without repair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93925","name":"Lower extremity study","description":"Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3503.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"86200","name":"Ccp antibody","description":"Cyclic citrullinated peptide (ccp), antibody","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78170","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2503.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2005","name":"Kafo sng/dbl mechanical act","description":"Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1034.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1126.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51530","name":"Removal of bladder lesion","description":"Cystotomy; for excision of bladder tumor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L0454","name":"Tlso trnk sj-t9 pre cst","description":"Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefa","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"00812","name":"Anes lwr intst scr colsc","description":"Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; screening colonoscopy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"75726","name":"Artery x-rays abdomen","description":"Angiography, visceral, selective or supraselective (with or without flush aortogram), radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26540","name":"Repair hand joint","description":"Repair of collateral ligament, metacarpophalangeal or interphalangeal joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":557.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55700","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"J0760","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1156.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1070","name":"Wheelchair detachable foot r","description":"Fully-reclining wheelchair, detachable arms (desk or full length) swing away detachable footrest","date_of_service":"2026-05-10","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":"27356","name":"Remove femur lesion/graft","description":"Excision or curettage of bone cyst or benign tumor of femur; with allograft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":865.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"43236","name":"Uppr gi scope w/submuc inj","description":"Esophagogastroduodenoscopy, flexible, transoral; with directed submucosal injection(s), any substance","date_of_service":"2026-05-10","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":"46730","name":"Construction of absent anus","description":"Repair of high imperforate anus without fistula; perineal or sacroperineal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41512","name":"Tongue suspension","description":"Tongue base suspension, permanent suture technique","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"75982","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20525","name":"Rmvl fb musc/tdn deep/comp","description":"Removal of foreign body in muscle or tendon sheath; deep or complicated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0637","name":"Lso sc r ant/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"44322","name":"Colostomy with biopsies","description":"Colostomy or skin level cecostomy; with multiple biopsies (eg, for congenital megacolon) (separate procedure)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70360","name":"X-ray exam of neck","description":"Radiologic examination; neck, soft tissue","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"44141","name":"Partial removal of colon","description":"Colectomy, partial; with skin level cecostomy or colostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"46211","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7040","name":"Normal saline solution infus","description":"Infusion, normal saline solution, sterile (500 ml = 1 unit)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":587.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51040","name":"Incise & drain bladder","description":"Cystostomy, cystotomy with drainage","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"95929","name":"C motor evoked lwr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); lower limbs","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29355","name":"Appl long leg cast walker","description":"Application of long leg cast (thigh to toes); walker or ambulatory type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64600","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent, trigeminal nerve; supraorbital, infraorbital, mental, or inferior alveolar branch","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30100","name":"Intranasal biopsy","description":"Biopsy, intranasal","date_of_service":"2026-05-10","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":"01214","name":"Anes open px tot hip arthrp","description":"Anesthesia for open procedures involving hip joint; total hip arthroplasty","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":"A4382","name":"Urinary hvy plstc pch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, heavy plastic, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"25426","name":"Repair/graft radius & ulna","description":"Repair of defect with autograft; radius and ulna","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J8521","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1508.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"0144T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27566","name":"Treat kneecap dislocation","description":"Open treatment of patellar dislocation, with or without partial or total patellectomy","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"50686","name":"Measure ureter pressure","description":"Manometric studies through ureterostomy or indwelling ureteral catheter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24134","name":"Sequestrectomy shft/dstl hum","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), shaft or distal humerus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":924.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4670","name":"Automatic bp monitor, dial","description":"Automatic blood pressure monitor","date_of_service":"2026-05-10","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":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51785","name":"Anal/urinary muscle study","description":"Needle electromyography studies (emg) of anal or urethral sphincter, any technique","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":780.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"33860","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2687.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2311","name":"Lens sphc trifo 7.25-12/.25-","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":514.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":711.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"00832","name":"Anes hernia repair vnt&incal","description":"Anesthesia for hernia repairs in lower abdomen; ventral and incisional hernias","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"85335","name":"Factor inhibitor test","description":"Factor inhibitor test","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"J1160","name":"Digoxin injection","description":"Injection, digoxin, up to 0.5 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83045","name":"Hgb methemoglobin qual","description":"Hemoglobin; methemoglobin, qualitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"25360","name":"Revision of ulna","description":"Osteotomy; ulna","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15336","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66170","name":"Glaucoma surgery","description":"Fistulization of sclera for glaucoma; trabeculectomy ab externo in absence of previous surgery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1113.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1221.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1235","name":"Rigid ped wc adjustable","description":"Wheelchair, pediatric size, rigid, adjustable, with seating system","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"0207T","name":"Clear eyelid gland w/heat","description":"Evacuation of meibomian glands, automated, using heat and intermittent pressure, unilateral","date_of_service":"2026-05-10","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":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4419","name":"Ost pch for bar w flange/flt","description":"Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25444","name":"Arthrp w/prostc lunate","description":"Arthroplasty with prosthetic replacement; lunate","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":994.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1010","name":"Ctlso axilla sling","description":"Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01360","name":"Anes open px lower 1/3 femur","description":"Anesthesia for all open procedures on lower one-third of femur","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"S4989","name":"Contracept iud","description":"Contraceptive intrauterine device (e.g., progestacert iud), including implants and supplies","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90952","name":"Esrd serv 2-3 vsts p mo <2yr","description":"End-stage renal disease (esrd) related services monthly, for patients younger than 2 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 2-3 face-to-face visits by a physician or other qualified health care professio","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0151T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4232","name":"Syringe w/needle insulin 3cc","description":"Syringe with needle for external insulin pump, sterile, 3 cc","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0220","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"74020","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23172","name":"Sequestrectomy scapula","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), scapula","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"G0332","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74742","name":"X-ray fallopian tube","description":"Transcervical catheterization of fallopian tube, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"42182","name":"Repair palate","description":"Repair, laceration of palate; over 2 cm or complex","date_of_service":"2026-05-10","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":"A4461","name":"Surgicl dress hold non-reuse","description":"Surgical dressing holder, non-reusable, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"77610","name":"Hyperthermia ntrstl prb 5/<","description":"Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.16,"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":"70544","name":"Mr angiography head w/o dye","description":"Magnetic resonance angiography, head; without contrast material(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2344.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["26"]}],"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":"2026-05-10","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":"A6206","name":"Contact layer <= 16 sq in","description":"Contact layer, sterile, 16 sq. in. or less, each dressing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4412","name":"Ost pouch drain high output","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"29065","name":"Appl cst sho to hand lng arm","description":"Application, cast; shoulder to hand (long arm)","date_of_service":"2026-05-10","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":"46604","name":"Anoscopy and dilation","description":"Anoscopy; with dilation (eg, balloon, guide wire, bougie)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4295","name":"Straigh tip hydrophilic cath","description":"Intermittent urinary catheter; straight tip, hydrophilic coating, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2725","name":"Inj protirelin per 250 mcg","description":"Injection, protirelin, per 250 mcg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"L1700","name":"Leg perthes orth toronto typ","description":"Legg perthes orthosis, (toronto type), custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43638","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1987.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KC"]}],"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":"2026-05-10","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":"33822","name":"Repair pda div<18 years","description":"Repair of patent ductus arteriosus; by division, younger than 18 years","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":884.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54865","name":"Explore epididymis","description":"Exploration of epididymis, with or without biopsy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41112","name":"Excision of tongue lesion","description":"Excision of lesion of tongue with closure; anterior two-thirds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"37226","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1650","name":"Ho abduction hip adjustable","description":"Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99186","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3977","name":"Sewhfo cap desgn w/jnt(s) cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":"27098","name":"Transfer tendon to pelvis","description":"Transfer, adductor to ischium","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45005","name":"Drainage of rectal abscess","description":"Incision and drainage of submucosal abscess, rectum","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6253","name":"Absorpt drg > 48 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","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":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1543.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"50360","name":"Rnl altrnsplj w/o rcp nfrct","description":"Renal allotransplantation, implantation of graft; without recipient nephrectomy","date_of_service":"2026-05-10","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":"75756","name":"Artery x-rays chest","description":"Angiography, internal mammary, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54400","name":"Insert semi-rigid prosthesis","description":"Insertion of penile prosthesis; non-inflatable (semi-rigid)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"75872","name":"Vein x-ray skull epidural","description":"Venography, epidural, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-10","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":"23474","name":"Revis reconst shoulder joint","description":"Revision of total shoulder arthroplasty, including allograft when performed; humeral and glenoid component","date_of_service":"2026-05-10","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":"78012","name":"Thyroid uptake measurement","description":"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2790.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15837","name":"Exc excsv skin forearm/hand","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); forearm or hand","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65140","name":"Attach ocular implant","description":"Insertion of ocular implant secondary; after enucleation, muscles attached to implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69602","name":"Rev mstdc rslt mod rad mstdc","description":"Revision mastoidectomy; resulting in modified radical mastoidectomy","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48148","name":"Removal of pancreatic duct","description":"Excision of ampulla of vater","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":556.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78140","name":"Red cell sequestration","description":"Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or hepatic)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93237","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23066","name":"Biopsy shoulder tissues","description":"Biopsy, soft tissue of shoulder area; deep","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":756.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4221","name":"Supp non-insulin inf cath/wk","description":"Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs  separately)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"87254","name":"Virus inoculation shell via","description":"Virus isolation; centrifuge enhanced (shell vial) technique, includes identification with immunofluorescence stain, each virus","date_of_service":"2026-05-10","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":"27745","name":"Reinforce tibia","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate, tibia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":641.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"71110","name":"X-ray exam ribs bil 3 views","description":"Radiologic examination, ribs, bilateral; 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86709","name":"Hepatitis a igm antibody","description":"Hepatitis a antibody (haab), igm antibody","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2496.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1059.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77065","name":"Dx mammo incl cad uni","description":"Diagnostic mammography, including computer-aided detection (cad) when performed; unilateral","date_of_service":"2026-05-10","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":"00630","name":"Anes px lumbar region nos","description":"Anesthesia for procedures in lumbar region; not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0710","name":"Ctlso a-p-l control w/ inter","description":"Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type)","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1659.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1833.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"85290","name":"Clot factor xiii fibrin stab","description":"Clotting; factor xiii (fibrin stabilizing)","date_of_service":"2026-05-10","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":"A4411","name":"Ost skn barr extnd =4sq","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0602","name":"Manual breast pump","description":"Breast pump, manual, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"77293","name":"Respirator motion mgmt simul","description":"Respiratory motion management simulation (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":602.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77063","name":"Breast tomosynthesis bi","description":"Screening digital breast tomosynthesis, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["TC"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0148T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-10","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":"31640","name":"Bronchoscopy w/tumor excise","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with excision of tumor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88344","name":"Imhchem/imcytchm ea mlt antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; each multiplex antibody stain procedure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["26"]}],"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":"2026-05-10","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":"L3973","name":"Sewho airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":"L5644","name":"Above knee wood socket","description":"Addition to lower extremity, above knee, wood socket","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4479","name":"Electro pump enema, reusable","description":"Electronic transanal irrigation system, includes electronic pump, water reservoir, tubing, and accessories, without catheter, any type","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"34501","name":"Repair valve femoral vein","description":"Valvuloplasty, femoral vein","date_of_service":"2026-05-10","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":"35634","name":"Bpg iliorenal","description":"Bypass graft, with other than vein; iliorenal","date_of_service":"2026-05-10","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":"85303","name":"Clot inhibit prot c activity","description":"Clotting inhibitors or anticoagulants; protein c, activity","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0636","name":"Lso sagittal rigid panel cus","description":"Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressu","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3031","name":"Foot lamin/prepreg composite","description":"Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"25405","name":"Repair/graft radius or ulna","description":"Repair of nonunion or malunion, radius or ulna; with autograft (includes obtaining graft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3002","name":"Foot insert plastazote or eq","description":"Foot, insert, removable, molded to patient model, plastazote or equal, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8631","name":"Mcp joint repl 2 pc or more","description":"Metacarpal phalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes entire system)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6675","name":"Harness figure of 8 sing con","description":"Upper extremity addition, harness, (e.g., figure of eight type), single cable design","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63707","name":"Repair spinal fluid leakage","description":"Repair of dural/cerebrospinal fluid leak, not requiring laminectomy","date_of_service":"2026-05-10","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":"A4217","name":"Sterile water/saline, 500 ml","description":"Sterile water/saline, 500 ml","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["AU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"78350","name":"Bone mineral single photon","description":"Bone density (bone mineral content) study, 1 or more sites; single photon absorptiometry","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83930","name":"Assay of blood osmolality","description":"Osmolality; blood","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88289","name":"Chromosome study additional","description":"Chromosome analysis; additional high resolution study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-10","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":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74455","name":"X-ray urethra/bladder","description":"Urethrocystography, voiding, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25107","name":"Remove wrist joint cartilage","description":"Arthrotomy, distal radioulnar joint including repair of triangular cartilage, complex","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-10","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":"59325","name":"Revision of cervix","description":"Cerclage of cervix, during pregnancy; abdominal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50100","name":"Trnsxj/repos abrrnt rnl vsls","description":"Transection or repositioning of aberrant renal vessels (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":947.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72080","name":"X-ray exam thoracolmb 2/> vw","description":"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L3670","name":"So acro/clav can web pre ots","description":"Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8609","name":"Artificial cornea","description":"Artificial cornea","date_of_service":"2026-05-10","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":"19020","name":"Mastotomy expl drg absc dp","description":"Mastotomy with exploration or drainage of abscess, deep","date_of_service":"2026-05-10","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":"90901","name":"Biofeedback train any meth","description":"Biofeedback training by any modality","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":387.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"G0344","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5540","name":"Prep bk ptb laminated socket","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33426","name":"Repair of mitral valve","description":"Valvuloplasty, mitral valve, with cardiopulmonary bypass; with prosthetic ring","date_of_service":"2026-05-10","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":"73070","name":"X-ray exam of elbow","description":"Radiologic examination, elbow; 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"L8609","name":"Artificial cornea","description":"Artificial cornea","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"71110","name":"X-ray exam ribs bil 3 views","description":"Radiologic examination, ribs, bilateral; 3 views","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"43639","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2010.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5703","name":"Symes ankle w/o (sach) foot","description":"Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":870.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1760","name":"Closure dev, vasc","description":"Closure device, vascular (implantable/insertable)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22505","name":"Manipulation of spine","description":"Manipulation of spine requiring anesthesia, any region","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28285","name":"Repair of hammertoe","description":"Correction, hammertoe (eg, interphalangeal fusion, partial or total phalangectomy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94450","name":"Breathing response hypoxia","description":"Breathing response to hypoxia (hypoxia response curve)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91030","name":"Acid perfusion of esophagus","description":"Esophagus, acid perfusion (bernstein) test for esophagitis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"28531","name":"Treat sesamoid bone fracture","description":"Open treatment of sesamoid fracture, with or without internal fixation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73562","name":"X-ray exam of knee 3","description":"Radiologic examination, knee; 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4411","name":"Ost skn barr extnd =4sq","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each","date_of_service":"2026-05-10","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":"91034","name":"Gastroesophageal reflux test","description":"Esophagus, gastroesophageal reflux test; with nasal catheter ph electrode(s) placement, recording, analysis and interpretation","date_of_service":"2026-05-10","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":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"36425","name":"Venipuncture cutdown 1 yr/>","description":"Venipuncture, cutdown; age 1 or over","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-05-10","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":"87592","name":"N.gonorrhoeae dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); neisseria gonorrhoeae, quantification","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52000","name":"Cystourethroscopy","description":"Cystourethroscopy (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6692","name":"Silicon gel insert w/wo lock","description":"Upper extremity addition, silicone gel insert or equal, with or without locking mechanism, each","date_of_service":"2026-05-10","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":"39541","name":"Repair of diaphragm hernia","description":"Repair, diaphragmatic hernia (other than neonatal), traumatic; chronic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1802","name":"Adjst forearm pro/sup device","description":"Dynamic adjustable forearm pronation/supination device, includes soft interface material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"S8185","name":"Flutter device","description":"Flutter device","date_of_service":"2026-05-10","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":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5679","name":"Socket insert w/o lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76100","name":"X-ray exam of body section","description":"Radiologic examination, single plane body section (eg, tomography), other than with urography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4070","name":"Replace prox & dist upright","description":"Replace proximal and distal upright for kafo","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9215","name":"Interferon alfa-n3 inj","description":"Injection, interferon, alfa-n3, (human leukocyte derived), 250,000 iu","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90686","name":"Iiv4 vacc no prsv 0.5 ml im","description":"Influenza virus vaccine, quadrivalent (iiv4), split virus, preservative free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","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":22.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38241","name":"Transplt autol hct/donor","description":"Hematopoietic progenitor cell (hpc); autologous transplantation","date_of_service":"2026-05-10","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":"33211","name":"Insert card electrodes dual","description":"Insertion or replacement of temporary transvenous dual chamber pacing electrodes (separate procedure)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6021","name":"Collagen dressing <=16 sq in","description":"Collagen dressing, sterile, size 16 sq. in. or less, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"82757","name":"Assay of semen fructose","description":"Fructose, semen","date_of_service":"2026-05-10","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":"0297T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"43775","name":"Lap sleeve gastrectomy","description":"Laparoscopy, surgical, gastric restrictive procedure; longitudinal gastrectomy (ie, sleeve gastrectomy)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1356.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64713","name":"Revision of arm nerve(s)","description":"Neuroplasty, major peripheral nerve, arm or leg, open; brachial plexus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4257","name":"Replace lensshield cartridge","description":"Replacement lens shield cartridge for use with laser skin piercing device, each","date_of_service":"2026-05-10","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":"51705","name":"Change of bladder tube","description":"Change of cystostomy tube; simple","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":835.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"87593","name":"Orthopoxvirus amp prb each","description":"Infectious agent detection by nucleic acid (dna or rna); orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each","date_of_service":"2026-05-10","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":51.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4008","name":"Cast sup long arm ped fbrgls","description":"Cast supplies, long arm cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"27003","name":"Tnot adductr subq opn neurct","description":"Tenotomy, adductor, subcutaneous, open, with obturator neurectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":503.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57295","name":"Revise vag graft via vagina","description":"Revision (including removal) of prosthetic vaginal graft; vaginal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"61798","name":"Srs cranial lesion complex","description":"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 complex cranial lesion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1256.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75558","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0983","name":"Add pwr joystick","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, joystick control","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":734.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":772.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77054","name":"X-ray of mammary ducts","description":"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-05-10","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":"44960","name":"Appendectomy","description":"Appendectomy; for ruptured appendix with abscess or generalized peritonitis","date_of_service":"2026-05-10","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":"92597","name":"Oral speech device eval","description":"Evaluation for use and/or fitting of voice prosthetic device to supplement oral speech","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97703","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"71047","name":"X-ray exam chest 3 views","description":"Radiologic examination, chest; 3 views","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57415","name":"Remove vaginal foreign body","description":"Removal of impacted vaginal foreign body (separate procedure) under anesthesia (other than local)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"75966","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24138","name":"Sequestrectomy olecrn proces","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), olecranon process","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4049","name":"Finger splint, static","description":"Finger splint, static","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0327","name":"Colon ca scrn;bld-bsd biomrk","description":"Colorectal cancer screening; blood-based biomarker","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77285","name":"Ther rad simulaj field intrm","description":"Therapeutic radiology simulation-aided field setting; intermediate","date_of_service":"2026-05-10","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":"62292","name":"Njx chemonucleolysis lmbr","description":"Injection procedure for chemonucleolysis, including discography, intervertebral disc, single or multiple levels, lumbar","date_of_service":"2026-05-10","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":"73070","name":"X-ray exam of elbow","description":"Radiologic examination, elbow; 2 views","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"57540","name":"Removal of residual cervix","description":"Excision of cervical stump, abdominal approach;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":889.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63250","name":"Revise spinal cord vsls crvl","description":"Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; cervical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84163","name":"Pappa serum","description":"Pregnancy-associated plasma protein-a (papp-a)","date_of_service":"2026-05-10","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":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","date_of_service":"2026-05-10","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":"E0658","name":"Seg pneum comp 2 arm chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full arms and chest","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":811.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0630","name":"Lso r post pnl sj-t9 pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1454.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR","KF",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"95834","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"70450","name":"Ct head/brain w/o dye","description":"Computed tomography, head or brain; without contrast material","date_of_service":"2026-05-10","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":"84446","name":"Assay of vitamin e","description":"Tocopherol alpha (vitamin e)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A5063","name":"Drain ostomy pouch w/flange","description":"Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70481","name":"Ct orbit/ear/fossa w/dye","description":"Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5160","name":"Mold socket bent knee shin s","description":"Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1050","name":"Sternal pad","description":"Addition to ctlso or scoliosis orthosis, sternal pad","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":765.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64644","name":"Chemodenerv 1 extrem 5/> mus","description":"Chemodenervation of one extremity; 5 or more muscles","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"51990","name":"Laparo urethral suspension","description":"Laparoscopy, surgical; urethral suspension for stress incontinence","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":890.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54530","name":"Removal of testis","description":"Orchiectomy, radical, for tumor; inguinal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70170","name":"X-ray exam of tear duct","description":"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"30465","name":"Repair nasal stenosis","description":"Repair of nasal vestibular stenosis (eg, spreader grafting, lateral nasal wall reconstruction)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"38531","name":"Open bx/exc inguinofem nodes","description":"Biopsy or excision of lymph node(s); open, inguinofemoral node(s)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50392","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"3074F","name":"Syst bp lt 130 mm hg","description":"Most recent systolic blood pressure less than 130 mm hg (dm) (htn, ckd, cad)","date_of_service":"2026-05-10","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":2.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"57456","name":"Endocerv curettage w/scope","description":"Colposcopy of the cervix including upper/adjacent vagina; with endocervical curettage","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"44025","name":"Incision of large bowel","description":"Colotomy, for exploration, biopsy(s), or foreign body removal","date_of_service":"2026-05-10","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":"61541","name":"Incision of brain tissue","description":"Craniotomy with elevation of bone flap; for transection of corpus callosum","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2376.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26496","name":"Revise thumb tendon","description":"Opponensplasty; other methods","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1038.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78268","name":"Urea breath test c-14 alys","description":"Urea breath test, c-14 (isotopic); analysis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88381","name":"Microdissection manual","description":"Microdissection (ie, sample preparation of microscopically identified target); manual","date_of_service":"2026-05-10","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":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-10","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":"L2106","name":"Afo tib fx cast plaster mold","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated","date_of_service":"2026-05-10","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":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-05-10","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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-10","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":"01214","name":"Anes open px tot hip arthrp","description":"Anesthesia for open procedures involving hip joint; total hip arthroplasty","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82666","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2267.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-10","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":"62304","name":"Myelography lumbar injection","description":"Myelography via lumbar injection, including radiological supervision and interpretation; lumbosacral","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"34900","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86277","name":"Growth hormone antibody","description":"Growth hormone, human (hgh), antibody","date_of_service":"2026-05-10","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":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"89130","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"94690","name":"O2 uptk rest indirect","description":"Oxygen uptake, expired gas analysis; rest, indirect (separate procedure)","date_of_service":"2026-05-10","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":"21045","name":"Extensive jaw surgery","description":"Excision of malignant tumor of mandible; radical resection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1344.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1323.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31288","name":"Nasal/sinus endoscopy surg","description":"Nasal/sinus endoscopy, surgical, with sphenoidotomy; with removal of tissue from the sphenoid sinus","date_of_service":"2026-05-10","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":"86592","name":"Syphilis test non-trep qual","description":"Syphilis test, non-treponemal antibody; qualitative (eg, vdrl, rpr, art)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","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":"2026-05-10","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":"23515","name":"Optx clavicular fx w/int fix","description":"Open treatment of clavicular fracture, includes internal fixation, when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":606.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80196","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86628","name":"Candida antibody","description":"Antibody; candida","date_of_service":"2026-05-10","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":"82397","name":"Chemiluminescent assay","description":"Chemiluminescent assay","date_of_service":"2026-05-10","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":"45341","name":"Sigmoidoscopy w/ultrasound","description":"Sigmoidoscopy, flexible; with endoscopic ultrasound examination","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"27052","name":"Biopsy of hip joint","description":"Arthrotomy, with biopsy; hip joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4352","name":"Coude tip urinary catheter","description":"Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6697","name":"Cus elbo skt in not con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-05-10","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":"82435","name":"Assay of blood chloride","description":"Chloride; blood","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76511","name":"Oph us dx quan a-scan only","description":"Ophthalmic ultrasound, diagnostic; quantitative a-scan only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":945.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37730","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":566.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1354.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83633","name":"Test urine for lactose","description":"Lactose, urine, qualitative","date_of_service":"2026-05-10","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":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"50200","name":"Renal biopsy perq","description":"Renal biopsy; percutaneous, by trocar or needle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"55810","name":"Extensive prostate surgery","description":"Prostatectomy, perineal radical;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1061.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51610","name":"Injection for bladder x-ray","description":"Injection procedure for retrograde urethrocystography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"00534","name":"Anes insertion/rplcmt cvdfb","description":"Anesthesia for transvenous insertion or replacement of pacing cardioverter-defibrillator","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27175","name":"Treat slipped epiphysis","description":"Treatment of slipped femoral epiphysis; by traction, without reduction","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6200","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78478","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":646.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KC"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"ATP22","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-10","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":"46611","name":"Anoscopy","description":"Anoscopy; with removal of single tumor, polyp, or other lesion by snare technique","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4005","name":"Cast sup long arm adult plst","description":"Cast supplies, long arm cast, adult (11 years +), plaster","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"48540","name":"Fuse pancreas cyst and bowel","description":"Internal anastomosis of pancreatic cyst to gastrointestinal tract; roux-en-y","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1350.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"21206","name":"Reconstruct upper jaw bone","description":"Osteotomy, maxilla, segmental (eg, wassmund or schuchard)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"V2218","name":"Lens aniseikonic bifocal","description":"Aniseikonic, per lens, bifocal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1266.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":615.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":680.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55535","name":"Revise spermatic cord veins","description":"Excision of varicocele or ligation of spermatic veins for varicocele; abdominal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43830","name":"Gstrst open wo constj tube","description":"Gastrostomy, open; without construction of gastric tube (eg, stamm procedure) (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0201","name":"Penile contractur devic manu","description":"Penile contracture device, manual, greater than 3 lbs traction force","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":581.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84270","name":"Assay of sex hormone globul","description":"Sex hormone binding globulin (shbg)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"77790","name":"Radiation handling","description":"Supervision, handling, loading of radiation source","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21100","name":"Maxillofacial fixation","description":"Application of halo type appliance for maxillofacial fixation, includes removal (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":532.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73525","name":"Contrast x-ray of hip","description":"Radiologic examination, hip, arthrography, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0280","name":"Bed cradle","description":"Bed cradle, any type","date_of_service":"2026-05-10","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":"33362","name":"Replace aortic valve open","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; open femoral artery approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1785.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2344.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77301","name":"Radiotherapy dose plan imrt","description":"Intensity modulated radiotherapy plan, including dose-volume histograms for target and critical structure partial tolerance specifications","date_of_service":"2026-05-10","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":"93886","name":"Intracranial complete study","description":"Transcranial doppler study of the intracranial arteries; complete study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11106","name":"Incal bx skn single les","description":"Incisional biopsy of skin (eg, wedge) (including simple closure, when performed); single lesion","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1229.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70380","name":"X-ray exam of salivary gland","description":"Radiologic examination, salivary gland for calculus","date_of_service":"2026-05-10","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":"71023","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33237","name":"Remove electrode/thoracotomy","description":"Removal of permanent epicardial pacemaker and electrodes by thoracotomy; dual lead system","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97028","name":"Ultraviolet therapy","description":"Application of a modality to 1 or more areas; ultraviolet","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49568","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A5055","name":"Stoma cap","description":"Stoma cap","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0182","name":"Replace pump, alt press pad","description":"Pump for alternating pressure pad, for replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99290","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.12,"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":"E1340","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-10","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":"33233","name":"Removal of pm generator","description":"Removal of permanent pacemaker pulse generator only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"63650","name":"Implant neuroelectrodes","description":"Percutaneous implantation of neurostimulator electrode array, epidural","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1536.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5505","name":"Diab shoe w/metatarsal bar","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with metatarsal bar, per shoe","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"66505","name":"Incision of iris","description":"Iridotomy by stab incision (separate procedure); with transfixion as for iris bombe","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59622","name":"Attempted vbac after care","description":"Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery; including postpartum care","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6706","name":"Term dev mech hook vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"U0004","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"76102","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83632","name":"Placental lactogen","description":"Lactogen, human placental (hpl) human chorionic somatomammotropin","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"51020","name":"Cystotomy/cystostomy w/fulg","description":"Cystotomy or cystostomy, with fulguration and/or insertion of radioactive material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"27080","name":"Removal of tail bone","description":"Coccygectomy, primary","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2650","name":"Pelv & thor control gluteal","description":"Addition to lower extremity, pelvic and thoracic control, gluteal pad, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"93543","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"93542","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3806","name":"Whfo w/joint(s) custom fab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"67414","name":"Explr/decompress eye socket","description":"Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of bone for decompression","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1068.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15630","name":"Delay flap eye/nos/ear/lip","description":"Delay of flap or sectioning of flap (division and inset); at eyelids, nose, ears, or lips","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":352.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"76100","name":"X-ray exam of body section","description":"Radiologic examination, single plane body section (eg, tomography), other than with urography","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35533","name":"Art byp grft axill/fem/fem","description":"Bypass graft, with vein; axillary-femoral-femoral","date_of_service":"2026-05-10","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":"67350","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"73610","name":"X-ray exam of ankle","description":"Radiologic examination, ankle; complete, minimum of 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35472","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85240","name":"Clot factor viii ahg 1 stage","description":"Clotting; factor viii (ahg), 1-stage","date_of_service":"2026-05-10","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":"87184","name":"Sc std disk method per plate","description":"Susceptibility studies, antimicrobial agent; disk method, per plate (12 or fewer agents)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4250","name":"Urine reagent strips/tablets","description":"Urine test or reagent strips or tablets (100 tablets or strips)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67036","name":"Removal of inner eye fluid","description":"Vitrectomy, mechanical, pars plana approach;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1822.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73510","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43647","name":"Lap impl electrode antrum","description":"Laparoscopy, surgical; implantation or replacement of gastric neurostimulator electrodes, antrum","date_of_service":"2026-05-10","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":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"80168","name":"Assay of ethosuximide","description":"Ethosuximide","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6154","name":"Wound pouch each","description":"Wound pouch, each","date_of_service":"2026-05-10","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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27465","name":"Shortening of thigh bone","description":"Osteoplasty, femur; shortening (excluding 64876)","date_of_service":"2026-05-10","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":"00802","name":"Anes px lwr abdl wal pannic","description":"Anesthesia for procedures on lower anterior abdominal wall; panniculectomy","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"67145","name":"Proph rta dtchmnt pc","description":"Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; photocoagulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"33212","name":"Insert pulse gen sngl lead","description":"Insertion of pacemaker pulse generator only; with existing single lead","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59025","name":"Fetal non-stress test","description":"Fetal non-stress test","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63610","name":"Stimulation of spinal cord","description":"Stereotactic stimulation of spinal cord, percutaneous, separate procedure not followed by other surgery","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"75885","name":"Vein x-ray liver w/hemodynam","description":"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"74235","name":"Remove esophagus obstruction","description":"Removal of foreign body(s), esophageal, with use of balloon catheter, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73560","name":"X-ray exam of knee 1 or 2","description":"Radiologic examination, knee; 1 or 2 views","date_of_service":"2026-05-10","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":"27750","name":"Treatment of tibia fracture","description":"Closed treatment of tibial shaft fracture (with or without fibular fracture); without manipulation","date_of_service":"2026-05-10","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":"31640","name":"Bronchoscopy w/tumor excise","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with excision of tumor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77763","name":"Apply intrcav radiat compl","description":"Intracavitary radiation source application; complex","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["KL"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0779","name":"Amb infusion pump mechanical","description":"Ambulatory infusion pump, mechanical, reusable, for infusion 8 hours or greater","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1859.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21300","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"J9219","name":"Leuprolide acetate implant","description":"Leuprolide acetate implant, 65 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2206.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"J1000","name":"Depo-estradiol cypionate inj","description":"Injection, depo-estradiol cypionate, up to 5 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-10","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":"92340","name":"Fit spectacles monofocal","description":"Fitting of spectacles, except for aphakia; monofocal","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":936.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2784","name":"Lens polycarb or equal","description":"Lens, polycarbonate or equal, any index, per lens","date_of_service":"2026-05-10","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":"58720","name":"Removal of ovary/tube(s)","description":"Salpingo-oophorectomy, complete or partial, unilateral or bilateral (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":825.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":933.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85300","name":"Antithrombin iii activity","description":"Clotting inhibitors or anticoagulants; antithrombin iii, activity","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1098.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64868","name":"Fusion of facial/other nerve","description":"Anastomosis; facial-hypoglossal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1208.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93731","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2184.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3809","name":"Whfo w/o joints pre ots","description":"Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33958","name":"Ecmo/ecls repos perph cnula","description":"Extracorporeal membrane oxygenation (ecmo)/extracorporeal life support (ecls) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), percutaneous, 6 years and older (includes fluoroscopic guidance, when performed)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1223","name":"Wheelchair spec size w foot","description":"Wheelchair with detachable arms, footrests","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1165.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27616","name":"Resect leg/ankle tum 5 cm/>","description":"Radical resection of tumor (eg, sarcoma), soft tissue of leg or ankle area; 5 cm or greater","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95911","name":"Nrv cndj test 9-10 studies","description":"Nerve conduction studies; 9-10 studies","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96420","name":"Chemo ia push tecnique","description":"Chemotherapy administration, intra-arterial; push technique","date_of_service":"2026-05-10","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":"87118","name":"Mycobacteric identification","description":"Culture, mycobacterial, definitive identification, each isolate","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77326","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85060","name":"Blood smear interpretation","description":"Blood smear, peripheral, interpretation by physician with written report","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"28496","name":"Treat big toe fracture","description":"Percutaneous skeletal fixation of fracture great toe, phalanx or phalanges, with manipulation","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"90702","name":"Dt vaccine under 7 yrs im","description":"Diphtheria and tetanus toxoids adsorbed (dt) when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"L3140","name":"Abduction rotation bar shoe","description":"Foot, abduction rotation bar, including shoes","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"25118","name":"Excise wrist tendon sheath","description":"Synovectomy, extensor tendon sheath, wrist, single compartment;","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"94750","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88154","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84181","name":"Western blot test","description":"Protein; western blot, with interpretation and report, blood or other body fluid","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"28660","name":"Treat toe dislocation","description":"Closed treatment of interphalangeal joint dislocation; without anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0205","name":"Heat lamp with stand","description":"Heat lamp, with stand, includes bulb, or infrared element","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J2280","name":"Inj, moxifloxacin 100 mg","description":"Injection, moxifloxacin, 100 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"27080","name":"Removal of tail bone","description":"Coccygectomy, primary","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":550.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"11100","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"74440","name":"X-ray male genital tract","description":"Vasography, vesiculography, or epididymography, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0418","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":621.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"47400","name":"Incision of liver duct","description":"Hepaticotomy or hepaticostomy with exploration, drainage, or removal of calculus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26070","name":"Explore/treat hand joint","description":"Arthrotomy, with exploration, drainage, or removal of loose or foreign body; carpometacarpal joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92504","name":"Ear microscopy examination","description":"Binocular microscopy (separate diagnostic procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27078","name":"Rsect hip tum incl femur","description":"Radical resection of tumor; ischial tuberosity and greater trochanter of femur","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33764","name":"Shunt central w/prostc graft","description":"Shunt; central, with prosthetic graft","date_of_service":"2026-05-10","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":"30600","name":"Repair mouth/nose fistula","description":"Repair fistula; oronasal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"00902","name":"Anes anorectal px","description":"Anesthesia for; anorectal procedure","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26536","name":"Revise/implant finger joint","description":"Arthroplasty, interphalangeal joint; with prosthetic implant, each joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84166","name":"Protein e-phoresis/urine/csf","description":"Protein; electrophoretic fractionation and quantitation, other fluids with concentration (eg, urine, csf)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4231","name":"Infusion insulin pump needle","description":"Infusion set for external insulin pump, needle type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"76100","name":"X-ray exam of body section","description":"Radiologic examination, single plane body section (eg, tomography), other than with urography","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83528","name":"Assay of intrinsic factor","description":"Intrinsic factor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-10","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":"J2271","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3923","name":"Hfo without joints pre cst","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26535","name":"Revise finger joint","description":"Arthroplasty, interphalangeal joint; each joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3740","name":"Cuffs adj lock w/ active con","description":"Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5683","name":"Initial custom socket insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95824","name":"Eeg cerebral death only","description":"Electroencephalogram (eeg); cerebral death evaluation only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"64623","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"78272","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"J9090","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"15837","name":"Exc excsv skin forearm/hand","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); forearm or hand","date_of_service":"2026-05-10","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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"84220","name":"Assay of pyruvate kinase","description":"Pyruvate kinase","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93503","name":"Insert/place heart catheter","description":"Insertion and placement of flow directed catheter (eg, swan-ganz) for monitoring purposes","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82565","name":"Assay of creatinine","description":"Creatinine; blood","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4437","name":"Irr supply sleev disp per mo","description":"Irrigation supply; sleeve, disposable, per month","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9027","name":"Clofarabine injection","description":"Injection, clofarabine, 1 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20975","name":"Estim aid bone healg invasiv","description":"Electrical stimulation to aid bone healing; invasive (operative)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0734","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0290T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78227","name":"Hepatobil syst image w/drug","description":"Hepatobiliary system imaging, including gallbladder when present; with pharmacologic intervention, including quantitative measurement(s) when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60200","name":"Remove thyroid lesion","description":"Excision of cyst or adenoma of thyroid, or transection of isthmus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90714","name":"Td vacc no presv 7 yrs+ im","description":"Tetanus and diphtheria toxoids adsorbed (td), preservative free, when administered to individuals 7 years or older, for intramuscular use","date_of_service":"2026-05-10","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":38.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00172","name":"Anes ntroral px rpr clft pal","description":"Anesthesia for intraoral procedures, including biopsy; repair of cleft palate","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0278T","name":"Tempr","description":"Transcutaneous electrical modulation pain reprocessing (eg, scrambler therapy), each treatment session (includes placement of electrodes)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"15171","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"92986","name":"Revision of aortic valve","description":"Percutaneous balloon valvuloplasty; aortic valve","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"L0639","name":"Lso s/c shell/panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-10","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":"74190","name":"Peritoneogram rs&i","description":"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69440","name":"Exploration of middle ear","description":"Middle ear exploration through postauricular or ear canal incision","date_of_service":"2026-05-10","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":"88318","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5999","name":"Lowr extremity prosthes nos","description":"Lower extremity prosthesis, not otherwise specified","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"31267","name":"Endoscopy maxillary sinus","description":"Nasal/sinus endoscopy, surgical, with maxillary antrostomy; with removal of tissue from maxillary sinus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2104.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43600","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1720","name":"Hydrocortisone sodium succ i","description":"Injection, hydrocortisone sodium succinate, up to 100 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3530","name":"Ortho shoe add half sole","description":"Orthopedic shoe addition, sole, half","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"64738","name":"Incision of jaw nerve","description":"Transection or avulsion of; inferior alveolar nerve by osteotomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25676","name":"Optx rad/uln dislc aqt/chrnc","description":"Open treatment of distal radioulnar dislocation, acute or chronic","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3051.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92546","name":"Sinusoidal rotational test","description":"Sinusoidal vertical axis rotational testing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":936.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77310","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E0572","name":"Aerosol compressor adjust pr","description":"Aerosol compressor, adjustable pressure, light duty for intermittent use","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1171","name":"Wheelchair amputee w/o leg r","description":"Amputee wheelchair, fixed full length arms, without footrests or legrest","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"15788","name":"Chemical peel facial epidrm","description":"Chemical peel, facial; epidermal","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"35470","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":555.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"63661","name":"Remove spine eltrd perq aray","description":"Removal of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38562","name":"Removal pelvic lymph nodes","description":"Limited lymphadenectomy for staging (separate procedure); pelvic and para-aortic","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":629.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"78806","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"J7189","name":"Factor viia recomb novoseven","description":"Factor viia (antihemophilic factor, recombinant), (novoseven rt), 1 microgram","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5200","name":"Kne sing axis fric shin sach","description":"Above knee, molded socket, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1640.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92997","name":"Pul art balloon repr percut","description":"Percutaneous transluminal pulmonary artery balloon angioplasty; single vessel","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"30140","name":"Resect inferior turbinate","description":"Submucous resection inferior turbinate, partial or complete, any method","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73120","name":"X-ray exam of hand","description":"Radiologic examination, hand; 2 views","date_of_service":"2026-05-10","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":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94772","name":"Circadian respir pattern rec","description":"Circadian respiratory pattern recording (pediatric pneumogram), 12-24 hour continuous recording, infant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88280","name":"Chromosome karyotype study","description":"Chromosome analysis; additional karyotypes, each study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0300","name":"Amobarbital 125 mg inj","description":"Injection, amobarbital, up to 125 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"53430","name":"Reconstruction of urethra","description":"Urethroplasty, reconstruction of female urethra","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1072.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["KE","NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1372","name":"Oxy suppl heater for nebuliz","description":"Immersion external heater for nebulizer","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1324.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KN"]}],"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":"2026-05-10","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":"45381","name":"Colonoscopy submucous njx","description":"Colonoscopy, flexible; with directed submucosal injection(s), any substance","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1789.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26550","name":"Pollicization digit","description":"Pollicization of a digit","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1859.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"55041","name":"Removal of hydroceles","description":"Excision of hydrocele; bilateral","date_of_service":"2026-05-10","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":"31579","name":"Laryngoscopy telescopic","description":"Laryngoscopy, flexible or rigid telescopic, with stroboscopy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"E1110","name":"Wheelchair semi-recl detach","description":"Semi-reclining wheelchair, detachable arms (desk or full length) elevating leg rest","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"76977","name":"Us bone density measure","description":"Ultrasound bone density measurement and interpretation, peripheral site(s), any method","date_of_service":"2026-05-10","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":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"27792","name":"Treatment of ankle fracture","description":"Open treatment of distal fibular fracture (lateral malleolus), includes internal fixation, when performed","date_of_service":"2026-05-10","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":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4018","name":"Cast sup lng arm splint fbrg","description":"Cast supplies, long arm splint, adult (11 years +), fiberglass","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0459","name":"Chest wrap","description":"Chest wrap","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"92561","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"49590","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":476.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64646","name":"Chemodenerv trunk musc 1-5","description":"Chemodenervation of trunk muscle(s); 1-5 muscle(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"32654","name":"Thoracoscopy contrl bleeding","description":"Thoracoscopy, surgical; with control of traumatic hemorrhage","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29425","name":"Appl short leg cast walking","description":"Application of short leg cast (below knee to toes); walking or ambulatory type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":337.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0912","name":"Hd trapeze bar free standing","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, free standing, complete with grab bar","date_of_service":"2026-05-10","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":"72074","name":"X-ray exam thorac spine4/>vw","description":"Radiologic examination, spine; thoracic, minimum of 4 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2118.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24153","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":780.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"28110","name":"Part removal of metatarsal","description":"Ostectomy, partial excision, fifth metatarsal head (bunionette) (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"73500","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"99273","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61304","name":"Crnec/crnot expl supratntorl","description":"Craniectomy or craniotomy, exploratory; supratentorial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1497.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1171","name":"Wheelchair amputee w/o leg r","description":"Amputee wheelchair, fixed full length arms, without footrests or legrest","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"44391","name":"Colonoscopy for bleeding","description":"Colonoscopy through stoma; with control of bleeding, any method","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":777.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75980","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KF"]}],"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":"2026-05-10","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":"33231","name":"Insrt pulse gen w/mult leads","description":"Insertion of implantable defibrillator pulse generator only; with existing multiple leads","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L6582","name":"Wrist/elbow bowden cbl dir f","description":"Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75953","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41827","name":"Excision of gum lesion","description":"Excision of lesion or tumor (except listed above), dentoalveolar structures; with complex repair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1110","name":"Ring flange plas/leather mol","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2500","name":"Thi/glut/ischia wgt bearing","description":"Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"S8460","name":"Camisole post-mast","description":"Camisole, post-mastectomy","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"77787","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"83630","name":"Lactoferrin fecal (qual)","description":"Lactoferrin, fecal; qualitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00542","name":"Anes thrcm px decortication","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); decortication","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"54560","name":"Exploration for testis","description":"Exploration for undescended testis with abdominal exploration","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":754.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0389","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5506","name":"Diabetic shoe w/off set heel","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with off-set heel(s), per shoe","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3638.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"49553","name":"Rpr fem hernia init blocked","description":"Repair initial femoral hernia, any age; incarcerated or strangulated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"Q4035","name":"Cast sup lngleg cylndr ped p","description":"Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6243","name":"Hydrogel drg >16<=48 w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68720","name":"Create tear sac drain","description":"Dacryocystorhinostomy (fistulization of lacrimal sac to nasal cavity)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":769.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70548","name":"Mr angiography neck w/dye","description":"Magnetic resonance angiography, neck; with contrast material(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00222","name":"Anes icr px ecoag icr nrv","description":"Anesthesia for intracranial procedures; electrocoagulation of intracranial nerve","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"91133","name":"Electrogastrography w/test","description":"Electrogastrography, diagnostic, transcutaneous; with provocative testing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"61684","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; infratentorial, simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28052","name":"Biopsy of foot joint lining","description":"Arthrotomy with biopsy; metatarsophalangeal joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0637","name":"Lso sc r ant/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21401","name":"Closed tx orbit w/manipulj","description":"Closed treatment of fracture of orbit, except blowout; with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77074","name":"Radex osseous survey lmtd","description":"Radiologic examination, osseous survey; limited (eg, for metastases)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"92561","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"35800","name":"Explore neck vessels","description":"Exploration for postoperative hemorrhage, thrombosis or infection; neck","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64561","name":"Implant neuroelectrodes","description":"Percutaneous implantation of neurostimulator electrode array; sacral nerve (transforaminal placement) including image guidance, if performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"J3415","name":"Pyridoxine hcl 100 mg","description":"Injection, pyridoxine hcl, 100 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1358.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":296.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1281.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":669.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65150","name":"Revise ocular implant","description":"Reinsertion of ocular implant; with or without conjunctival graft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0694","name":"Cefoxitin sodium injection","description":"Injection, cefoxitin sodium, 1 gm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1789.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6452","name":"High compres band w>=3in<5inyd","description":"High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"31725","name":"Clearance of airways","description":"Catheter aspiration (separate procedure); tracheobronchial with fiberscope, bedside","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82595","name":"Assay of cryoglobulin","description":"Cryoglobulin, qualitative or semi-quantitative (eg, cryocrit)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"58825","name":"Transposition ovary(s)","description":"Transposition, ovary(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22600","name":"Arthrd pst tq 1ntrspc crv","description":"Arthrodesis, posterior or posterolateral technique, single interspace; cervical below c2 segment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"35482","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73200","name":"Ct upper extremity w/o dye","description":"Computed tomography, upper extremity; without contrast material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41826","name":"Excision of gum lesion","description":"Excision of lesion or tumor (except listed above), dentoalveolar structures; with simple repair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":213.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0621","name":"Sio flex pelvic/sacr pre ots","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"L5856","name":"Elec knee-shin swing/stance","description":"Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9100","name":"Cytarabine hcl 100 mg inj","description":"Injection, cytarabine, 100 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78645","name":"Csf shunt evaluation","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52640","name":"Relieve bladder contracture","description":"Transurethral resection; of postoperative bladder neck contracture","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58976","name":"Transfer of embryo","description":"Gamete, zygote, or embryo intrafallopian transfer, any method","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"50630","name":"Removal of ureter stone","description":"Ureterolithotomy; lower one-third of ureter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3471","name":"Ovine, up to 999 usp units","description":"Injection, hyaluronidase, ovine, preservative free, per 1 usp unit (up to 999 usp units)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-10","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":"35482","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2738.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26555","name":"Positional change of finger","description":"Transfer, finger to another position without microvascular anastomosis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1155.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50948","name":"Laparo new ureter/bladder","description":"Laparoscopy, surgical; ureteroneocystostomy without cystoscopy and ureteral stent placement","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1433.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"47802","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0480","name":"Tlso rigid plastic custom fa","description":"Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, res","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0462","name":"Rocking bed w/ or w/o side r","description":"Rocking bed with or without side rails","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4352","name":"Coude tip urinary catheter","description":"Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each","date_of_service":"2026-05-10","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":"84030","name":"Assay of blood pku","description":"Phenylalanine (pku), blood","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"10080","name":"I&d pilonidal cyst simple","description":"Incision and drainage of pilonidal cyst; simple","date_of_service":"2026-05-10","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":"60512","name":"Autotransplant parathyroid","description":"Parathyroid autotransplantation (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"68520","name":"Removal of tear sac","description":"Excision of lacrimal sac (dacryocystectomy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":685.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42825","name":"Removal of tonsils","description":"Tonsillectomy, primary or secondary; younger than age 12","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1060","name":"Wheelchair detachable arms","description":"Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4081","name":"Enteral ng tubing w/ stylet","description":"Nasogastric tubing with stylet","date_of_service":"2026-05-10","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":"97542","name":"Wheelchair mngment training","description":"Wheelchair management (eg, assessment, fitting, training), each 15 minutes","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"70240","name":"X-ray exam pituitary saddle","description":"Radiologic examination, sella turcica","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"90650","name":"2vhpv vaccine 3 dose im","description":"Human papillomavirus vaccine, types 16, 18, bivalent (2vhpv), 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":632.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5810","name":"Endoskel knee-shin mnl lock","description":"Addition, endoskeletal knee-shin system, single axis, manual lock","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78195","name":"Lymph system imaging","description":"Lymphatics and lymph nodes imaging","date_of_service":"2026-05-10","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":"77332","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; simple (simple block, simple bolus)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0491","name":"Emr pwr source combo vad rep","description":"Emergency power source for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"0467T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1193.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.64,"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":"92604","name":"Reprogram cochlear implt 7/>","description":"Diagnostic analysis of cochlear implant, age 7 years or older; subsequent reprogramming","date_of_service":"2026-05-10","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":"L6050","name":"Wrst mld sck flx hng tri pad","description":"Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1099.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66700","name":"Destruction ciliary body","description":"Ciliary body destruction; diathermy","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"29425","name":"Appl short leg cast walking","description":"Application of short leg cast (below knee to toes); walking or ambulatory type","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":995.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92065","name":"Orthop traing pfrmd phys/qhp","description":"Orthoptic training; performed by a physician or other qualified health care professional","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7400","name":"Add ue prost be/wd, ultlite","description":"Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55200","name":"Incision of sperm duct","description":"Vasotomy, cannulization with or without incision of vas, unilateral or bilateral (separate procedure)","date_of_service":"2026-05-10","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":"37205","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23031","name":"I&d shoulder infected bursa","description":"Incision and drainage, shoulder area; infected bursa","date_of_service":"2026-05-10","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":"43425","name":"Repair esophagus opening","description":"Closure of esophagostomy or fistula; transthoracic or transabdominal approach","date_of_service":"2026-05-10","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":"61552","name":"Release of skull seams","description":"Craniectomy for craniosynostosis; multiple cranial sutures","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78104","name":"Bone marrow imaging body","description":"Bone marrow imaging; whole body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80182","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1825","name":"Adjust finger ext & flex dev","description":"Dynamic adjustable finger extension and flexion device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","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":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","date_of_service":"2026-05-10","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":"25107","name":"Remove wrist joint cartilage","description":"Arthrotomy, distal radioulnar joint including repair of triangular cartilage, complex","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27393","name":"Lengthening of thigh tendon","description":"Lengthening of hamstring tendon; single tendon","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"J9080","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"A6526","name":"G com garmt full leg/ft nght","description":"Gradient compression garment, full leg and foot, padded, for nighttime use, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"69222","name":"Clean out mastoid cavity","description":"Debridement, mastoidectomy cavity, complex (eg, with anesthesia or more than routine cleaning)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"64856","name":"Repair/transpose nerve","description":"Suture of major peripheral nerve, arm or leg, except sciatic; including transposition","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1134.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":364.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR","KF",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20526","name":"Ther injection carp tunnel","description":"Injection, therapeutic (eg, local anesthetic, corticosteroid), carpal tunnel","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"41512","name":"Tongue suspension","description":"Tongue base suspension, permanent suture technique","date_of_service":"2026-05-10","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":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":907.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"86803","name":"Hepatitis c ab test","description":"Hepatitis c antibody;","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2431.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2037","name":"Kafo plas sing free knee mol","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"83925","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L2405","name":"Knee joint drop lock ea jnt","description":"Addition to knee joint, drop lock, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"31502","name":"Change of windpipe airway","description":"Tracheotomy tube change prior to establishment of fistula tract","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0725","name":"Chorionic gonadotropin/1000u","description":"Injection, chorionic gonadotropin, per 1,000 usp units","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"21116","name":"Injection jaw joint x-ray","description":"Injection procedure for temporomandibular joint arthrography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63185","name":"Incise spine nrv half segmnt","description":"Laminectomy with rhizotomy; 1 or 2 segments","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28820","name":"Amputation of toe","description":"Amputation, toe; metatarsophalangeal joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23333","name":"Remove shoulder fb deep","description":"Removal of foreign body, shoulder; deep (subfascial or intramuscular)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4271","name":"Home lancing/test cartridges","description":"Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66940","name":"Extraction of lens","description":"Removal of lens material; extracapsular (other than 66840, 66850, 66852)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28126","name":"Partial removal of toe","description":"Resection, partial or complete, phalangeal base, each toe","date_of_service":"2026-05-10","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":"91060","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64802","name":"Sympathectomy cervical","description":"Sympathectomy, cervical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":751.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"L6038","name":"Multiax rotation attachment","description":"Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5520","name":"Perp bk ptb thermopls direct","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31368","name":"Partial removal of larynx","description":"Laryngectomy; subtotal supraglottic, with radical neck dissection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86648","name":"Diphtheria antibody","description":"Antibody; diphtheria","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"50234","name":"Removal of kidney & ureter","description":"Nephrectomy with total ureterectomy and bladder cuff; through same incision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1058.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33221","name":"Insert pulse gen mult leads","description":"Insertion of pacemaker pulse generator only; with existing multiple leads","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0734","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"36013","name":"Place catheter in artery","description":"Introduction of catheter, right heart or main pulmonary artery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"33238","name":"Remove electrode/thoracotomy","description":"Removal of permanent transvenous electrode(s) by thoracotomy","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0744","name":"Neuromuscular stim for scoli","description":"Neuromuscular stimulator for scoliosis","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0620","name":"Cap bld skin piercing laser","description":"Skin piercing device for collection of capillary blood, laser, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88388","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"54385","name":"Repair penis","description":"Plastic operation on penis for epispadias distal to external sphincter; with incontinence","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.94,"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":"E0941","name":"Gravity assisted traction de","description":"Gravity assisted traction device, any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"85337","name":"Thrombomodulin","description":"Thrombomodulin","date_of_service":"2026-05-10","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":"92569","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"88358","name":"Analysis tumor","description":"Morphometric analysis; tumor (eg, dna ploidy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":374.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93232","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79445","name":"Nuclear rx intra-arterial","description":"Radiopharmaceutical therapy, by intra-arterial particulate administration","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":557.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"82785","name":"Assay of ige","description":"Gammaglobulin (immunoglobulin); ige","date_of_service":"2026-05-10","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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","date_of_service":"2026-05-10","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":"E0560","name":"Humidifier supplemental w/ i","description":"Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11011","name":"Debride skin musc at fx site","description":"Debridement including removal of foreign material at the site of an open fracture and/or an open dislocation (eg, excisional debridement); skin, subcutaneous tissue, muscle fascia, and muscle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26615","name":"Treat metacarpal fracture","description":"Open treatment of metacarpal fracture, single, includes internal fixation, when performed, each bone","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1513.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01935","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27884","name":"Amputation follow-up surgery","description":"Amputation, leg, through tibia and fibula; secondary closure or scar revision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A6252","name":"Absorpt drg >16 <=48 w/o bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"98925","name":"Osteopath manj 1-2 regions","description":"Osteopathic manipulative treatment (omt); 1-2 body regions involved","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"85270","name":"Clot factor xi pta","description":"Clotting; factor xi (pta)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1002.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0648","name":"Lso sag r an/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1131.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":997.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5512","name":"Multi den insert direct form","description":"For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patients foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78707","name":"K flow/funct image w/o drug","description":"Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46740","name":"Construction of absent anus","description":"Repair of high imperforate anus with rectourethral or rectovaginal fistula; perineal or sacroperineal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2000.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"90822","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"46500","name":"Injection into hemorrhoid(s)","description":"Injection of sclerosing solution, hemorrhoids","date_of_service":"2026-05-10","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":"E0560","name":"Humidifier supplemental w/ i","description":"Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery","date_of_service":"2026-05-10","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":"G2023","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"63275","name":"Bx/exc xdrl spine lesn crvl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, cervical","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70491","name":"Ct soft tissue neck w/dye","description":"Computed tomography, soft tissue neck; with contrast material(s)","date_of_service":"2026-05-10","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":"L0484","name":"Tlso rigid plastic cust fab","description":"Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by ov","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":726.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":794.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3760","name":"Eo adj jt prefab custom fit","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific  patient by an individual with expertise","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4432","name":"Os pch urine w bar/fange/tap","description":"Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94729","name":"Diffusing capacity","description":"Diffusing capacity (eg, carbon monoxide, membrane) (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"75964","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":760.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"V2210","name":"Lens sphcy bifocal 4.25-7/ov","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2770","name":"Occluder lens/es","description":"Occluder lens, per lens","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A6564","name":"G com stckng waist 40+ cust","description":"Gradient compression stocking, waist length, 40 mmhg or greater, custom, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":477.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"B9004","name":"Parenteral infus pump portab","description":"Parenteral nutrition infusion pump, portable","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5826","name":"Miniature knee joint","description":"Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2112","name":"Spherocylindr 7.25d/2.25-4d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens","date_of_service":"2026-05-10","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":"90911","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6531","name":"Compress stking bk30-40 surg","description":"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-10","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":"1111F","name":"Dschrg med/current med merge","description":"Discharge medications reconciled with the current medication list in outpatient medical record (coa) (ger)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78012","name":"Thyroid uptake measurement","description":"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33218","name":"Repair lead pace-defib one","description":"Repair of single transvenous electrode, permanent pacemaker or implantable defibrillator","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28120","name":"Part removal of ankle/heel","description":"Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing); talus or calcaneus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":480.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"25210","name":"Removal of wrist bone","description":"Carpectomy; 1 bone","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5966","name":"Hip flexible cover system","description":"Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":508.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-10","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":"58260","name":"Vaginal hysterectomy","description":"Vaginal hysterectomy, for uterus 250 g or less;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2134","name":"Kafo fem fx cast semi-rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":"78258","name":"Esophageal motility","description":"Esophageal motility","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64491","name":"Inj paravert f jnt c/t 2 lev","description":"Injection(s), diagnostic or therapeutic agent, paravertebral facet (zygapophyseal) joint (or nerves innervating that joint) with image guidance (fluoroscopy or ct), cervical or thoracic; second level (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70487","name":"Ct maxillofacial w/dye","description":"Computed tomography, maxillofacial area; with contrast material(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"63191","name":"Incise spine accessory nerve","description":"Laminectomy with section of spinal accessory nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1631.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"10180","name":"I&d complex po wound infctj","description":"Incision and drainage, complex, postoperative wound infection","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"61875","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4314","name":"Cath w/drainage 2-way latex","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70355","name":"Panoramic x-ray of jaws","description":"Orthopantogram (eg, panoramic x-ray)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"70460","name":"Ct head/brain w/dye","description":"Computed tomography, head or brain; with contrast material(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78070","name":"Parathyroid planar imaging","description":"Parathyroid planar imaging (including subtraction, when performed);","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59200","name":"Insert cervical dilator","description":"Insertion of cervical dilator (eg, laminaria, prostaglandin) (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1910","name":"Afo sing bar clasp attach sh","description":"Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85576","name":"Blood platelet aggregation","description":"Platelet, aggregation (in vitro), each agent","date_of_service":"2026-05-10","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":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["26"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00566","name":"Anes direct cabg w/o pump","description":"Anesthesia for direct coronary artery bypass grafting; without pump oxygenator","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":566.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"97018","name":"Paraffin bath therapy","description":"Application of a modality to 1 or more areas; paraffin bath","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"26437","name":"Realignment of tendons","description":"Realignment of extensor tendon, hand, each tendon","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91052","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"3079F","name":"Diast bp 80-89 mm hg","description":"Most recent diastolic blood pressure 80-89 mm hg (htn, ckd, cad) (dm)","date_of_service":"2026-05-10","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":2.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"0148T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"20501","name":"Njx sinus tract diagnostic","description":"Injection of sinus tract; diagnostic (sinogram)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","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":"L7360","name":"Six volt bat otto bock/eq ea","description":"Six volt battery, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-10","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":"L8627","name":"Cid ext speech process repl","description":"Cochlear implant, external speech processor, component, replacement","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63688","name":"Rev/rmv imp sp npg/r dtch cn","description":"Revision or removal of implanted spinal neurostimulator pulse generator or receiver, with detachable connection to electrode array","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75964","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01829","name":"Anes dx arthroscopic px wrst","description":"Anesthesia for diagnostic arthroscopic procedures on the wrist","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"20805","name":"Replant forearm complete","description":"Replantation, forearm (includes radius and ulna to radial carpal joint), complete amputation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3976.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63660","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33935","name":"Transplantation heart/lung","description":"Heart-lung transplant with recipient cardiectomy-pneumonectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4330.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":514.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85651","name":"Rbc sed rate nonautomated","description":"Sedimentation rate, erythrocyte; non-automated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4009","name":"Cast sup sht arm adult plstr","description":"Cast supplies, short arm cast, adult (11 years +), plaster","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22850","name":"Remove spine fixation device","description":"Removal of posterior nonsegmental instrumentation (eg, harrington rod)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":851.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"58805","name":"Drainage of ovarian cyst(s)","description":"Drainage of ovarian cyst(s), unilateral or bilateral (separate procedure); abdominal approach","date_of_service":"2026-05-10","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":"93888","name":"Intracranial limited study","description":"Transcranial doppler study of the intracranial arteries; limited study","date_of_service":"2026-05-10","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":"88388","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85557","name":"Rbc osmotic fragility","description":"Osmotic fragility, rbc; incubated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64702","name":"Revise finger/toe nerve","description":"Neuroplasty; digital, 1 or both, same digit","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00144","name":"Anes px eye corneal trnspl","description":"Anesthesia for procedures on eye; corneal transplant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27687","name":"Revision of calf tendon","description":"Gastrocnemius recession (eg, strayer procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"94150","name":"Vital capacity test","description":"Vital capacity, total (separate procedure)","date_of_service":"2026-05-10","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":"75840","name":"Vein x-ray adrenal gland","description":"Venography, adrenal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54560","name":"Exploration for testis","description":"Exploration for undescended testis with abdominal exploration","date_of_service":"2026-05-10","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":"87495","name":"Cytomeg dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); cytomegalovirus, direct probe technique","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35341","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; mesenteric, celiac, or renal","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-10","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":"0421T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":"20526","name":"Ther injection carp tunnel","description":"Injection, therapeutic (eg, local anesthetic, corticosteroid), carpal tunnel","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1680","name":"Pelvic & hip control thigh c","description":"Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1493.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4366","name":"Ostomy vent","description":"Ostomy vent, any type, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1286.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J8610","name":"Methotrexate oral 2.5 mg","description":"Methotrexate; oral, 2.5 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0983","name":"Add pwr joystick","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, joystick control","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5540","name":"Prep bk ptb laminated socket","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model","date_of_service":"2026-05-10","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":"74445","name":"X-ray exam of penis","description":"Corpora cavernosography, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"25105","name":"Remove wrist joint lining","description":"Arthrotomy, wrist joint; with synovectomy","date_of_service":"2026-05-10","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":"28022","name":"Exploration of foot joint","description":"Arthrotomy, including exploration, drainage, or removal of loose or foreign body; metatarsophalangeal joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48556","name":"Removal allograft pancreas","description":"Removal of transplanted pancreatic allograft","date_of_service":"2026-05-10","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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2102.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82627","name":"Dehydroepiandrosterone","description":"Dehydroepiandrosterone-sulfate (dhea-s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1228.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0740","name":"Non-implant pelv flr e-stim","description":"Non-implanted pelvic floor electrical stimulator, complete system","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35522","name":"Art byp grft axill-brachial","description":"Bypass graft, with vein; axillary-brachial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1482.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1974.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67412","name":"Explore/treat eye socket","description":"Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of lesion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1072.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48145","name":"Partial removal of pancreas","description":"Pancreatectomy, distal subtotal, with or without splenectomy; with pancreaticojejunostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6544","name":"Gc stocking garter belt","description":"Gradient compression stocking, garter belt","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6454","name":"Self-adher band w>=3in <5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-10","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":"87102","name":"Fungus isolation culture","description":"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; other source (except blood)","date_of_service":"2026-05-10","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":"A4929","name":"Tourniquet for dialysis, ea","description":"Tourniquet for dialysis, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"31000","name":"Irrigation maxillary sinus","description":"Lavage by cannulation; maxillary sinus (antrum puncture or natural ostium)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"53200","name":"Biopsy of urethra","description":"Biopsy of urethra","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"75946","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63198","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73500","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G0202","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"85400","name":"Fibrinolytic plasmin","description":"Fibrinolytic factors and inhibitors; plasmin","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6925","name":"Wrist disart myoelectronic c","description":"Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","21","49","02","65","81","32","11","24","22","33","10","13","12","31"],"billing_code_modifier":["GT","GQ","95","93","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81015","name":"Microscopic exam of urine","description":"Urinalysis; microscopic only","date_of_service":"2026-05-10","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":"81189","name":"Cstb gene full gene sequence","description":"Cstb (cystatin b) (eg, unverricht-lundborg disease) gene analysis; full gene sequence","date_of_service":"2026-05-10","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":"63172","name":"Drainage of spinal cyst","description":"Laminectomy with drainage of intramedullary cyst/syrinx; to subarachnoid space","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1249.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26531","name":"Revise knuckle with implant","description":"Arthroplasty, metacarpophalangeal joint; with prosthetic implant, each joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":738.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8000","name":"Mastectomy bra","description":"Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"A4565","name":"Slings","description":"Slings","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33243","name":"Remove eltrd/thoracotomy","description":"Removal of single or dual chamber implantable defibrillator electrode(s); by thoracotomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1185.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"A6229","name":"Gauze >16<=48 sq in watr/sal","description":"Gauze, impregnated, water or normal saline, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"64425","name":"Njx aa&/strd ii ih nerves","description":"Injection(s), anesthetic agent(s) and/or steroid; ilioinguinal, iliohypogastric nerves","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39401","name":"Mediastinoscpy w/medstnl bx","description":"Mediastinoscopy; includes biopsy(ies) of mediastinal mass (eg, lymphoma), when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75894","name":"X-rays transcath therapy","description":"Transcatheter therapy, embolization, any method, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":873.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82646","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":727.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"G0328","name":"Fecal blood scrn immunoassay","description":"Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1515.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J3150","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G0365","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"84586","name":"Assay of vip","description":"Vasoactive intestinal peptide (vip)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82010","name":"Ketone bodys quan","description":"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative","date_of_service":"2026-05-10","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":"71250","name":"Ct thorax dx c-","description":"Computed tomography, thorax, diagnostic; without contrast material","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"50605","name":"Insert ureteral support","description":"Ureterotomy for insertion of indwelling stent, all types","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"01772","name":"Anes art upr arm&elbw emblc","description":"Anesthesia for procedures on arteries of upper arm and elbow; embolectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"26785","name":"Treat finger dislocation","description":"Open treatment of interphalangeal joint dislocation, includes internal fixation, when performed, single","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94725","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96900","name":"Actinotherapy uv light","description":"Actinotherapy (ultraviolet light)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86359","name":"T cells total count","description":"T cells; total count","date_of_service":"2026-05-10","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":"0564T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":530.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1782.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21243","name":"Reconstruction of jaw joint","description":"Arthroplasty, temporomandibular joint, with prosthetic joint replacement","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31502","name":"Change of windpipe airway","description":"Tracheotomy tube change prior to establishment of fistula tract","date_of_service":"2026-05-10","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":"28320","name":"Repair of foot bones","description":"Repair, nonunion or malunion; tarsal bones","date_of_service":"2026-05-10","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":"51530","name":"Removal of bladder lesion","description":"Cystotomy; for excision of bladder tumor","date_of_service":"2026-05-10","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":"64622","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"64505","name":"N block spenopalatine gangl","description":"Injection, anesthetic agent; sphenopalatine ganglion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2120","name":"Pulse gen sys tx endolymp fl","description":"Pulse generator system for tympanic treatment of inner ear endolymphatic fluid","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64555","name":"Implant neuroelectrodes","description":"Percutaneous implantation of neurostimulator electrode array; peripheral nerve (excludes sacral nerve)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76870","name":"Us exam scrotum","description":"Ultrasound, scrotum and contents","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"87281","name":"Pneumocystis carinii ag if","description":"Infectious agent antigen detection by immunofluorescent technique; pneumocystis carinii","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":733.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00522","name":"Anes clsd ch px ndl bx pleur","description":"Anesthesia for closed chest procedures; needle biopsy of pleura","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58346","name":"Insert heyman uteri capsule","description":"Insertion of heyman capsules for clinical brachytherapy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J9031","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61875","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1212.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74290","name":"Contrast x-ray gallbladder","description":"Cholecystography, oral contrast","date_of_service":"2026-05-10","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":"76830","name":"Transvaginal us non-ob","description":"Ultrasound, transvaginal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83586","name":"Assay 17- ketosteroids","description":"Ketosteroids, 17- (17-ks); total","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"84156","name":"Assay of protein urine","description":"Protein, total, except by refractometry; urine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6208","name":"Contact layer > 48 sq in","description":"Contact layer, sterile, more than 48 sq. in., each dressing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1881.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33501","name":"Repair heart vessel fistula","description":"Repair of coronary arteriovenous or arteriocardiac chamber fistula; without cardiopulmonary bypass","date_of_service":"2026-05-10","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":"86329","name":"Immunodiffusion nes","description":"Immunodiffusion; not elsewhere specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5822","name":"Endo knee-shin pneum swg frc","description":"Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78647","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62291","name":"Njx px discography crv/thrc","description":"Injection procedure for discography, each level; cervical or thoracic","date_of_service":"2026-05-10","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":"82271","name":"Occult blood other sources","description":"Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"96401","name":"Chemo anti-neopl sq/im","description":"Chemotherapy administration, subcutaneous or intramuscular; non-hormonal anti-neoplastic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"44150","name":"Removal of colon","description":"Colectomy, total, abdominal, without proctectomy; with ileostomy or ileoproctostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1740.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96103","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64470","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8031","name":"Breast prosthesis w adhesive","description":"Breast prosthesis, silicone or equal, with integral adhesive","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78012","name":"Thyroid uptake measurement","description":"Thyroid uptake, single or multiple quantitative measurement(s) (including stimulation, suppression, or discharge, when performed)","date_of_service":"2026-05-10","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":"88161","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; preparation, screening and interpretation","date_of_service":"2026-05-10","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":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4010","name":"Cast sup sht arm adult fbrgl","description":"Cast supplies, short arm cast, adult (11 years +), fiberglass","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82139","name":"Amino acids quan 6 or more","description":"Amino acids, 6 or more amino acids, quantitative, each specimen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":654.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46211","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00812","name":"Anes lwr intst scr colsc","description":"Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; screening colonoscopy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"35551","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"50948","name":"Laparo new ureter/bladder","description":"Laparoscopy, surgical; ureteroneocystostomy without cystoscopy and ureteral stent placement","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"56720","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87542","name":"Legion pneumo dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); legionella pneumophila, quantification","date_of_service":"2026-05-10","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":"L6696","name":"Cus elbo skt in for con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"J2997","name":"Alteplase recombinant","description":"Injection, alteplase recombinant, 1 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8499","name":"Unlisted misc prosthetic ser","description":"Unlisted procedure for miscellaneous prosthetic services","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6641","name":"Excursion amplifier pulley t","description":"Upper extremity addition, excursion amplifier, pulley type","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2762","name":"Polarization, any lens","description":"Polarization, any lens material, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"28705","name":"Arthrodesis pantalar","description":"Arthrodesis; pantalar","date_of_service":"2026-05-10","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":"11101","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"86146","name":"Beta-2 glycoprotein antibody","description":"Beta 2 glycoprotein i antibody, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5460","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6721","name":"Hook/hand, hvy dty, vol open","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"92585","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"89105","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8609","name":"Artificial cornea","description":"Artificial cornea","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76775","name":"Us exam abdo back wall lim","description":"Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20955","name":"Fibula bone graft microvasc","description":"Bone graft with microvascular anastomosis; fibula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3062.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1718.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J3130","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":513.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":882.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"G0418","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1289.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3150","name":"Abduct rotation bar w/o shoe","description":"Foot, abduction rotation bar, without shoes","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6250","name":"Elbow inter loc elbow forarm","description":"Above elbow, molded double wall socket, internal locking elbow, forearm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"J2680","name":"Fluphenazine decanoate 25 mg","description":"Injection, fluphenazine decanoate, up to 25 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"21196","name":"Reconst lwr jaw w/fixation","description":"Reconstruction of mandibular rami and/or body, sagittal split; with internal rigid fixation","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"58540","name":"Revision of uterus","description":"Hysteroplasty, repair of uterine anomaly (strassman type)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1039.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["QB","RR","QF"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.6,"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":"26230","name":"Partial removal of hand bone","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis); metacarpal","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1249.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6590","name":"Shdr fair lead cable direct","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1187.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0461","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32555","name":"Aspirate pleura w/ imaging","description":"Thoracentesis, needle or catheter, aspiration of the pleural space; with imaging guidance","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":717.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1213.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"78206","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1040","name":"Lumbar or lumbar rib pad","description":"Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77013","name":"Ct guide for tissue ablation","description":"Computed tomography guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"27424","name":"Revision/removal of kneecap","description":"Reconstruction of dislocating patella; with patellectomy","date_of_service":"2026-05-10","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":"74160","name":"Ct abdomen w/contrast","description":"Computed tomography, abdomen; with contrast material(s)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73592","name":"X-ray exam of leg infant","description":"Radiologic examination; lower extremity, infant, minimum of 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82977","name":"Assay of ggt","description":"Glutamyltransferase, gamma (ggt)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00880","name":"Anes maj lwr abd vessel nos","description":"Anesthesia for procedures on major lower abdominal vessels; not otherwise specified","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6454","name":"Self-adher band w>=3in <5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":502.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"84260","name":"Assay of serotonin","description":"Serotonin","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1648.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4414","name":"Ost sknbar w/o conv<=4 sq in","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33400","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2167.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"45381","name":"Colonoscopy submucous njx","description":"Colonoscopy, flexible; with directed submucosal injection(s), any substance","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"76965","name":"Echo guidance radiotherapy","description":"Ultrasonic guidance for interstitial radioelement application","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A9282","name":"Wig any type","description":"Wig, any type, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1160","name":"Wheelchair fixed arms","description":"Wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":745.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":602.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23440","name":"Remove/transplant tendon","description":"Resection or transplantation of long tendon of biceps","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":637.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44130","name":"Bowel to bowel fusion","description":"Enteroenterostomy, anastomosis of intestine, with or without cutaneous enterostomy (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1003.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"93540","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"43622","name":"Removal of stomach","description":"Gastrectomy, total; with formation of intestinal pouch, any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2195.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":518.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"49204","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E1228","name":"Wheelchair spec sz spec ht b","description":"Special back height for wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76516","name":"Echo exam of eye","description":"Ophthalmic biometry by ultrasound echography, a-scan;","date_of_service":"2026-05-10","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":"52355","name":"Cystouretero w/excise tumor","description":"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with resection of ureteral or renal pelvic tumor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":377.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21280","name":"Medial canthopexy","description":"Medial canthopexy (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1801.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20103","name":"Expl pentrg wound extremity","description":"Exploration of penetrating wound (separate procedure); extremity","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":423.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4338","name":"Indwelling catheter latex","description":"Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"00144","name":"Anes px eye corneal trnspl","description":"Anesthesia for procedures on eye; corneal transplant","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1037.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0202","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8612","name":"Aqueous shunt prosthesis","description":"Aqueous shunt","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"43855","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-10","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":"11954","name":"Subq njx fil matrl>10.0 cc","description":"Subcutaneous injection of filling material (eg, collagen); over 10.0 cc","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28415","name":"Optx calcaneal fracture","description":"Open treatment of calcaneal fracture, includes internal fixation, when performed;","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2481.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82489","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"21077","name":"Impres&prep orbital prosth","description":"Impression and custom preparation; orbital prosthesis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":865.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78806","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75827","name":"Vein x-ray chest","description":"Venography, caval, superior, with serialography, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0466","name":"Home vent non-invasive inter","description":"Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2513","name":"Sgd accessory, emg sensor","description":"Accessory for speech generating device, electromyographic sensor","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"V2315","name":"Lens lenticular trifocal","description":"Lenticular, (myodisc), per lens, trifocal","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":717.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90648","name":"Hib prp-t vaccine 4 dose im","description":"Haemophilus influenzae type b vaccine (hib), prp-t conjugate, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","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":15.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61760","name":"Implant brain electrodes","description":"Stereotactic implantation of depth electrodes into the cerebrum for long-term seizure monitoring","date_of_service":"2026-05-10","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":"78730","name":"Urinary bladder retention","description":"Urinary bladder residual study (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71130","name":"X-ray strenoclavic jt 3/>vws","description":"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84703","name":"Chorionic gonadotropin assay","description":"Gonadotropin, chorionic (hcg); qualitative","date_of_service":"2026-05-10","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":"80184","name":"Assay of phenobarbital","description":"Phenobarbital","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":875.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"87169","name":"Macroscopic exam parasite","description":"Macroscopic examination; parasite","date_of_service":"2026-05-10","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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29915","name":"Hip arthro acetabuloplasty","description":"Arthroscopy, hip, surgical; with acetabuloplasty (ie, treatment of pincer lesion)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82926","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4615","name":"Cannula nasal","description":"Cannula, nasal","date_of_service":"2026-05-10","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":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":583.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"28175","name":"Resect phalanx of toe tumor","description":"Radical resection of tumor; phalanx of toe","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"44204","name":"Laparo partial colectomy","description":"Laparoscopy, surgical; colectomy, partial, with anastomosis","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1234.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0239","name":"Hydrocollator unit portable","description":"Hydrocollator unit, portable","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1144.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76061","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74742","name":"X-ray fallopian tube","description":"Transcervical catheterization of fallopian tube, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KC"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"76497","name":"Unlisted ct procedure","description":"Unlisted computed tomography procedure (eg, diagnostic, interventional)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"01962","name":"Anes urgent hysterectomy","description":"Anesthesia for urgent hysterectomy following delivery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":523.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q9947","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","date_of_service":"2026-05-10","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":"72200","name":"X-ray exam si joints","description":"Radiologic examination, sacroiliac joints; less than 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"76970","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1843","name":"Ko single upright pre cst","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a sp","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50700","name":"Revision of ureter","description":"Ureteroplasty, plastic operation on ureter (eg, stricture)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96542","name":"Chemotherapy injection","description":"Chemotherapy injection, subarachnoid or intraventricular via subcutaneous reservoir, single or multiple agents","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21422","name":"Optx palatal/max fracture","description":"Open treatment of palatal or maxillary fracture (lefort i type);","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73521","name":"X-ray exam hips bi 2 views","description":"Radiologic examination, hips, bilateral, with pelvis when performed; 2 views","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2321","name":"Hand interface joystick","description":"Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"39560","name":"Resect diaphragm simple","description":"Resection, diaphragm; with simple repair (eg, primary suture)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":687.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67121","name":"Remove eye implant material","description":"Removal of implanted material, posterior segment; intraocular","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":543.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83090","name":"Assay of homocysteine","description":"Homocysteine","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97012","name":"Mechanical traction therapy","description":"Application of a modality to 1 or more areas; traction, mechanical","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7016","name":"Nebulizer dome & mouthpiece","description":"Dome and mouthpiece, used with small volume ultrasonic nebulizer","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"44135","name":"Intestine transplnt cadaver","description":"Intestinal allotransplantation; from cadaver donor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1152.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83735","name":"Assay of magnesium","description":"Magnesium","date_of_service":"2026-05-10","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":"L5728","name":"Knee-shin fluid swg & stance","description":"Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00539","name":"Anes tracheobronchial rcnstj","description":"Anesthesia for tracheobronchial reconstruction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.94,"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":"75805","name":"Lymph vessel x-ray trunk","description":"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"E0246","name":"Transfer tub rail attachment","description":"Transfer tub rail attachment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69620","name":"Myringoplasty","description":"Myringoplasty (surgery confined to drumhead and donor area)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84315","name":"Body fluid specific gravity","description":"Specific gravity (except urine)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83857","name":"Assay of methemalbumin","description":"Methemalbumin","date_of_service":"2026-05-10","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":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":950.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32906","name":"Revise & repair chest wall","description":"Thoracoplasty, schede type or extrapleural (all stages); with closure of bronchopleural fistula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1320.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"73010","name":"X-ray exam of shoulder blade","description":"Radiologic examination; scapula, complete","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"00126","name":"Anes px ear tympanotomy","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; tympanotomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"25449","name":"Revj arthrp wrist joint","description":"Revision of arthroplasty, including removal of implant, wrist joint","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2610","name":"Hip clevis/thrust bearing lo","description":"Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21325","name":"Open tx nose fx uncomplicatd","description":"Open treatment of nasal fracture; uncomplicated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":812.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72080","name":"X-ray exam thoracolmb 2/> vw","description":"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01220","name":"Anes clsd px upper 2/3 femur","description":"Anesthesia for all closed procedures involving upper two-thirds of femur","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75756","name":"Artery x-rays chest","description":"Angiography, internal mammary, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3475","name":"Inj magnesium sulfate","description":"Injection, magnesium sulfate, per 500 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6600","name":"Polycentric hinge pair","description":"Upper extremity additions, polycentric hinge, pair","date_of_service":"2026-05-10","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":"64475","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"29240","name":"Strapping of shoulder","description":"Strapping; shoulder (eg, velpeau)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2373.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6214","name":"Foam drg > 48 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"G6005","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63281","name":"Bx/exc idrl spine lesn thrc","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, thoracic","date_of_service":"2026-05-10","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":"65101","name":"Removal of eye","description":"Enucleation of eye; without implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":763.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":694.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2292","name":"Planar seat for ped size wc","description":"Seat, planar, for pediatric size wheelchair including fixed attaching hardware","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":517.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","KF",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15823","name":"Blepharp upr eyelid xcsv skn","description":"Blepharoplasty, upper eyelid; with excessive skin weighting down lid","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8510","name":"Voice amplifier","description":"Voice amplifier","date_of_service":"2026-05-10","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":"21480","name":"Cltx tmprmand dislc 1st/sbsq","description":"Closed treatment of temporomandibular dislocation; initial or subsequent","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1596.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1196.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-05-10","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":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1017.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72072","name":"X-ray exam thorac spine 3vws","description":"Radiologic examination, spine; thoracic, 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0487","name":"Leads any type vad, rep only","description":"Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0482","name":"Tlso rigid lined custom fab","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","date_of_service":"2026-05-10","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":"L3455","name":"Shoe heel new leather standa","description":"Heel, new leather, standard","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1602.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":523.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5514","name":"Mult den insert dir carv/cam","description":"For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patients foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes ar","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"78011","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2192","name":"Pelvic band & belt thigh fla","description":"Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"65175","name":"Removal of ocular implant","description":"Removal of ocular implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"31070","name":"Exploration of frontal sinus","description":"Sinusotomy frontal; external, simple (trephine operation)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44397","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2104.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1137.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1468.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2282.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","KN"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2430","name":"Pamidronate disodium /30 mg","description":"Injection, pamidronate disodium, per 30 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","date_of_service":"2026-05-10","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":"29863","name":"Hip arthr0 w/synovectomy","description":"Arthroscopy, hip, surgical; with synovectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":901.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1717.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"83051","name":"Hemoglobin plasma","description":"Hemoglobin; plasma","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":758.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78805","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86800","name":"Thyroglobulin antibody","description":"Thyroglobulin antibody","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8435","name":"Pros sock multi ply upper lm","description":"Prosthetic sock, multiple ply, upper limb, each","date_of_service":"2026-05-10","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":"00190","name":"Anes px facial b1/skull nos","description":"Anesthesia for procedures on facial bones or skull; not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"33332","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"32657","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1047.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77075","name":"Radex osseous survey compl","description":"Radiologic examination, osseous survey; complete (axial and appendicular skeleton)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"87102","name":"Fungus isolation culture","description":"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; other source (except blood)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92342","name":"Fit spectacles multifocal","description":"Fitting of spectacles, except for aphakia; multifocal, other than bifocal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"68525","name":"Biopsy of tear sac","description":"Biopsy of lacrimal sac","date_of_service":"2026-05-10","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":"L1685","name":"Post-op hip abduct custom fa","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3510","name":"Orthopedic shoe add rub insl","description":"Orthopedic shoe addition, insole, rubber","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6525","name":"G com garm lwrleg/ft ngt cus","description":"Gradient compression garment, lower leg and foot, padded, for nighttime use, custom, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4014","name":"Cast sup gauntlet fiberglass","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51736","name":"Urine flow measurement","description":"Simple uroflowmetry (ufr) (eg, stop-watch flow rate, mechanical uroflowmeter)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77411","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"55812","name":"Extensive prostate surgery","description":"Prostatectomy, perineal radical; with lymph node biopsy(s) (limited pelvic lymphadenectomy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1766.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"70336","name":"Magnetic image jaw joint","description":"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43502","name":"Surgical repair of stomach","description":"Gastrotomy; with suture repair of pre-existing esophagogastric laceration (eg, mallory-weiss)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KC"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88164","name":"Cytopath tbs c/v manual","description":"Cytopathology, slides, cervical or vaginal (the bethesda system); manual screening under physician supervision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["QB","RR","QF"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83012","name":"Assay of haptoglobins","description":"Haptoglobin; phenotypes","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1580.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"67880","name":"Revision of eyelid","description":"Construction of intermarginal adhesions, median tarsorrhaphy, or canthorrhaphy;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"21337","name":"Closed tx septal&nose fx","description":"Closed treatment of nasal septal fracture, with or without stabilization","date_of_service":"2026-05-10","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":"64632","name":"N block inj common digit","description":"Destruction by neurolytic agent; plantar common digital nerve","date_of_service":"2026-05-10","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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86161","name":"Complement/function activity","description":"Complement; functional activity, each component","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"23331","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":624.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45339","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92274","name":"Multifocal erg w/i&r","description":"Electroretinography (erg), with interpretation and report; multifocal (mferg)","date_of_service":"2026-05-10","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":"56821","name":"Colposcopy vulva w/biopsy","description":"Colposcopy of the vulva; with biopsy(s)","date_of_service":"2026-05-10","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":"76818","name":"Fetal biophys profile w/nst","description":"Fetal biophysical profile; with non-stress testing","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"L3923","name":"Hfo without joints pre cst","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1250.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97024","name":"Diathermy eg microwave","description":"Application of a modality to 1 or more areas; diathermy (eg, microwave)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33271","name":"Insj subq impltbl dfb elctrd","description":"Insertion of subcutaneous implantable defibrillator electrode","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":579.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-10","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":"24930","name":"Amputation follow-up surgery","description":"Amputation, arm through humerus; re-amputation","date_of_service":"2026-05-10","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":"29901","name":"Mcp joint arthroscopy surg","description":"Arthroscopy, metacarpophalangeal joint, surgical; with debridement","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"58553","name":"Laparo-vag hyst complex","description":"Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1344.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"J9097","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92545","name":"Oscillating tracking test","description":"Oscillating tracking test, with recording","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27886","name":"Amputation follow-up surgery","description":"Amputation, leg, through tibia and fibula; re-amputation","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":655.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67005","name":"Partial removal of eye fluid","description":"Removal of vitreous, anterior approach (open sky technique or limbal incision); partial removal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"00632","name":"Anes px lumbar sympathectomy","description":"Anesthesia for procedures in lumbar region; lumbar sympathectomy","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78580","name":"Lung perfusion imaging","description":"Pulmonary perfusion imaging (eg, particulate)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00210","name":"Anes intracranial px nos","description":"Anesthesia for intracranial procedures; not otherwise specified","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"L2275","name":"Plastic mod low ext pad/line","description":"Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55810","name":"Extensive prostate surgery","description":"Prostatectomy, perineal radical;","date_of_service":"2026-05-10","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":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72291","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"74327","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"27381","name":"Repair/graft kneecap tendon","description":"Suture of infrapatellar tendon; secondary reconstruction, including fascial or tendon graft","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1078.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00147","name":"Anes px on eye iridectomy","description":"Anesthesia for procedures on eye; iridectomy","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":"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":"2026-05-10","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":"00500","name":"Anes all px on esophagus","description":"Anesthesia for all procedures on esophagus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"67500","name":"Inject/treat eye socket","description":"Retrobulbar injection; medication (separate procedure, does not include supply of medication)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3480","name":"Inj potassium chloride","description":"Injection, potassium chloride, per 2 meq","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1271.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27305","name":"Incise thigh tendon & fascia","description":"Fasciotomy, iliotibial (tenotomy), open","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":312.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"70170","name":"X-ray exam of tear duct","description":"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"78588","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KC"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2382.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27500","name":"Treatment of thigh fracture","description":"Closed treatment of femoral shaft fracture, without manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33917","name":"Repair pulmonary artery","description":"Repair of pulmonary artery stenosis by reconstruction with patch or graft","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1078.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31382","name":"Partial removal of larynx","description":"Partial laryngectomy (hemilaryngectomy); antero-latero-vertical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1584.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0530","name":"Electronic posa treatment","description":"Electronic positional obstructive sleep apnea treatment, with sensor, includes all components and accessories, any type","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","date_of_service":"2026-05-10","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":"42809","name":"Remove pharynx foreign body","description":"Removal of foreign body from pharynx","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","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":"23100","name":"Arthrotomy glenhumrl jt w/bx","description":"Arthrotomy, glenohumeral joint, including biopsy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":423.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92630","name":"Aud rehab pre-ling hear loss","description":"Auditory rehabilitation; prelingual hearing loss","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","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":"83904","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"76101","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26670","name":"Treat hand dislocation","description":"Closed treatment of carpometacarpal dislocation, other than thumb, with manipulation, each joint; without anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4483","name":"Moisture exchanger","description":"Moisture exchanger, disposable, for use with invasive mechanical ventilation","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31375","name":"Partial removal of larynx","description":"Partial laryngectomy (hemilaryngectomy); laterovertical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4918","name":"Venous pressure clamp","description":"Venous pressure clamp, for hemodialysis, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L6034","name":"Part hand finger distal amp","description":"Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at distal to metacarpal joint, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l669","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73200","name":"Ct upper extremity w/o dye","description":"Computed tomography, upper extremity; without contrast material","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"69662","name":"Revise middle ear bone","description":"Revision of stapedectomy or stapedotomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"29894","name":"Ankle arthroscopy/surgery","description":"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; with removal of loose body or foreign body","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5981","name":"Flex-walk sys low ext prosth","description":"All lower extremity prostheses, flex-walk system or equal","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78601","name":"Brain image w/flow < 4 views","description":"Brain imaging, less than 4 static views; with vascular flow","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"67405","name":"Explore/drain eye socket","description":"Orbitotomy without bone flap (frontal or transconjunctival approach); with drainage only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7525","name":"Tacrolimus injection","description":"Tacrolimus, parenteral, 5 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-05-10","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":"59841","name":"Induced abortion dilat&evac","description":"Induced abortion, by dilation and evacuation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"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":"75900","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1110.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0730","name":"Tens four lead","description":"Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2268.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37195","name":"Thrombolytic therapy stroke","description":"Thrombolysis, cerebral, by intravenous infusion","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1466.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7631","name":"Cromolyn sodium noncomp unit","description":"Cromolyn sodium, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per 10 milligrams","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"41827","name":"Excision of gum lesion","description":"Excision of lesion or tumor (except listed above), dentoalveolar structures; with complex repair","date_of_service":"2026-05-10","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":"76818","name":"Fetal biophys profile w/nst","description":"Fetal biophysical profile; with non-stress testing","date_of_service":"2026-05-10","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":"31511","name":"Remove foreign body larynx","description":"Laryngoscopy, indirect; with removal of foreign body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1908.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4407","name":"Ext wear ost skn barr <=4sqin","description":"Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"01650","name":"Anes art sho&ax nos","description":"Anesthesia for procedures on arteries of shoulder and axilla; not otherwise specified","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"G0120","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"73552","name":"X-ray exam of femur 2/>","description":"Radiologic examination, femur; minimum 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":"43310","name":"Repair of esophagus","description":"Esophagoplasty (plastic repair or reconstruction), thoracic approach; without repair of tracheoesophageal fistula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1778.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1200","name":"Furnsh initial orthosis only","description":"Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"Q2021","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1129.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2034","name":"Kafo pla sin up w/wo k/a cus","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1306.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"10140","name":"I&d hmtma seroma/fluid collj","description":"Incision and drainage of hematoma, seroma or fluid collection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85305","name":"Clot inhibit prot s total","description":"Clotting inhibitors or anticoagulants; protein s, total","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2166.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"24147","name":"Prtl exc bone olecrn process","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), olecranon process","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":523.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3390","name":"Shoe outflare wedge","description":"Outflare wedge","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28080","name":"Removal of foot lesion","description":"Excision, interdigital (morton) neuroma, single, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44152","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1907.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":"86341","name":"Islet cell antibody","description":"Islet cell antibody","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27893","name":"Decompression of leg","description":"Decompression fasciotomy, leg; posterior compartment(s) only, with debridement of nonviable muscle and/or nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"29870","name":"Arthrs knee dx w/wo syn bx","description":"Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":465.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L1280","name":"Rib gusset (elastic) each","description":"Addition to tlso, (low profile), rib gusset (elastic), each","date_of_service":"2026-05-10","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":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1463.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1388.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74245","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57540","name":"Removal of residual cervix","description":"Excision of cervical stump, abdominal approach;","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-10","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":"42600","name":"Closure of salivary fistula","description":"Closure salivary fistula","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43204","name":"Esoph scope w/sclerosis inj","description":"Esophagoscopy, flexible, transoral; with injection sclerosis of esophageal varices","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71090","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"01990","name":"Physiol support hrvg organs","description":"Physiological support for harvesting of organ(s) from brain-dead patient","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2221","name":"Lenticular lens, bifocal","description":"Lenticular lens, per lens, bifocal","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95869","name":"Ndl emg thrc paraspinal musc","description":"Needle electromyography; thoracic paraspinal muscles (excluding t1 or t12)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50392","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"49585","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7003","name":"Nebulizer administration set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77411","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59012","name":"Fetal cord puncture prenatal","description":"Cordocentesis (intrauterine), any method","date_of_service":"2026-05-10","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":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.78,"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":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"19030","name":"Njx px only mam ducto/glcto","description":"Injection procedure only for mammary ductogram or galactogram","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42962","name":"Control throat bleeding","description":"Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); with secondary surgical intervention","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":609.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"73550","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23473","name":"Revis reconst shoulder joint","description":"Revision of total shoulder arthroplasty, including allograft when performed; humeral or glenoid component","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8020","name":"Mastectomy form","description":"Breast prosthesis, mastectomy form","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6207","name":"Contact layer >16<= 48 sq in","description":"Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85732","name":"Thromboplastin time partial","description":"Thromboplastin time, partial (ptt); substitution, plasma fractions, each","date_of_service":"2026-05-10","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":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96105","name":"Assessment of aphasia","description":"Assessment of aphasia (includes assessment of expressive and receptive speech and language function, language comprehension, speech production ability, reading, spelling, writing, eg, by boston diagnostic aphasia examination) with interpretation and report, per hour","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","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":"72195","name":"Mri pelvis w/o dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s)","date_of_service":"2026-05-10","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":"88319","name":"Enzyme histochemistry","description":"Special stain including interpretation and report; group iii, for enzyme constituents","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"11041","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"92953","name":"Temporary external pacing","description":"Temporary transcutaneous pacing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45562","name":"Exploration/repair of rectum","description":"Exploration, repair, and presacral drainage for rectal injury;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7047","name":"Resp suction oral interface","description":"Oral interface used with respiratory suction pump, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96111","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2513","name":"Contact lens extended wear","description":"Contact lens, gas permeable, extended wear, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8614","name":"Cochlear device","description":"Cochlear device, includes all internal and external components","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33478","name":"Revision of heart chamber","description":"Outflow tract augmentation (gusset), with or without commissurotomy or infundibular resection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1363.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26520","name":"Release knuckle contracture","description":"Capsulectomy or capsulotomy; metacarpophalangeal joint, each joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33665","name":"Repair of heart defects","description":"Repair of intermediate or transitional atrioventricular canal, with or without atrioventricular valve repair","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73020","name":"X-ray exam of shoulder","description":"Radiologic examination, shoulder; 1 view","date_of_service":"2026-05-10","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":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43030","name":"Cricopharyngeal myotomy","description":"Cricopharyngeal myotomy","date_of_service":"2026-05-10","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":"64862","name":"Repair of low back nerves","description":"Suture of; lumbar plexus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1641.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67221","name":"Ocular photodynamic ther","description":"Destruction of localized lesion of choroid (eg, choroidal neovascularization); photodynamic therapy (includes intravenous infusion)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"76932","name":"Echo guide for heart biopsy","description":"Ultrasonic guidance for endomyocardial biopsy, imaging supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77077","name":"Joint survey single view","description":"Joint survey, single view, 2 or more joints (specify)","date_of_service":"2026-05-10","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":"93562","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"41822","name":"Excision of gum lesion","description":"Excision of fibrous tuberosities, dentoalveolar structures","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":863.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KF"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1090.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KM"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92569","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57530","name":"Removal of cervix","description":"Trachelectomy (cervicectomy), amputation of cervix (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76077","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0636","name":"Pt support & positioning sys","description":"Multipositional patient support system, with integrated lift, patient accessible controls","date_of_service":"2026-05-10","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":"E1195","name":"Wheelchair amputee heavy dut","description":"Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"78480","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6712","name":"Ped term dev, hook, vol clos","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1070","name":"Wheelchair detachable foot r","description":"Fully-reclining wheelchair, detachable arms (desk or full length) swing away detachable footrest","date_of_service":"2026-05-10","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":"30901","name":"Control of nosebleed","description":"Control nasal hemorrhage, anterior, simple (limited cautery and/or packing) any method","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","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":"38220","name":"Dx bone marrow aspirations","description":"Diagnostic bone marrow; aspiration(s)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"31615","name":"Trcheobrnchsc est trachs inc","description":"Tracheobronchoscopy through established tracheostomy incision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0251","name":"Hosp bed fixd ht w/o mattres","description":"Hospital bed, fixed height, with any type side rails, without mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46762","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":857.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"29840","name":"Wrist arthroscopy","description":"Arthroscopy, wrist, diagnostic, with or without synovial biopsy (separate procedure)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1578.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35112","name":"Repair artery rupture spleen","description":"Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, splenic artery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"78020","name":"Thyroid met uptake","description":"Thyroid carcinoma metastases uptake (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J0460","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1256.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56441","name":"Lysis of labial adhesions","description":"Lysis of labial adhesions","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":480.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53605","name":"Dilate urethra stricture","description":"Dilation of urethral stricture or vesical neck by passage of sound or urethral dilator, male, general or conduction (spinal) anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"20694","name":"Rmvl ext fixj sys under anes","description":"Removal, under anesthesia, of external fixation system","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47741","name":"Fuse gallbladder & bowel","description":"Cholecystoenterostomy; roux-en-y with gastroenterostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-10","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":"44701","name":"Intraop colon lavage add-on","description":"Intraoperative colonic lavage (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00520","name":"Anes closed chest px nos","description":"Anesthesia for closed chest procedures; (including bronchoscopy) not otherwise specified","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"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":"2026-05-10","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":"35490","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":721.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1168.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"92130","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6220","name":"Gauze >16 <=48 sq in w/bordr","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-10","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":"42700","name":"I&d abscess peritonsillar","description":"Incision and drainage abscess; peritonsillar","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73565","name":"X-ray exam of knees","description":"Radiologic examination, knee; both knees, standing, anteroposterior","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86682","name":"Helminth antibody","description":"Antibody; helminth, not elsewhere specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"71020","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2020","name":"Kafo dbl solid stirrup band/","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar ak orthosis), custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":836.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0487","name":"Leads any type vad, rep only","description":"Leads (pneumatic/electrical) for use with any type electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","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":"74182","name":"Mri abdomen w/contrast","description":"Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22521","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"70100","name":"X-ray exam of jaw <4views","description":"Radiologic examination, mandible; partial, less than 4 views","date_of_service":"2026-05-10","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":"15300","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"76946","name":"Echo guide for amniocentesis","description":"Ultrasonic guidance for amniocentesis, imaging supervision and interpretation","date_of_service":"2026-05-10","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":"88365","name":"Insitu hybridization (fish)","description":"In situ hybridization (eg, fish), per specimen; initial single probe stain procedure","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1099.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":797.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4211.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"93014","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"65410","name":"Biopsy of cornea","description":"Biopsy of cornea","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":997.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1297.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"44800","name":"Excision of bowel pouch","description":"Excision of meckels diverticulum (diverticulectomy) or omphalomesenteric duct","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"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":"92532","name":"Positional nystagmus test","description":"Positional nystagmus test","date_of_service":"2026-05-10","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":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84466","name":"Assay of transferrin","description":"Transferrin","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"78230","name":"Salivary gland imaging","description":"Salivary gland imaging;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3370","name":"Shoe sole wedge between sole","description":"Sole wedge, between sole","date_of_service":"2026-05-10","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":"35621","name":"Bpg axillary-femoral","description":"Bypass graft, with other than vein; axillary-femoral","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"54240","name":"Penile plethysmography","description":"Penile plethysmography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4346","name":"Cath indw foley 3 way","description":"Indwelling catheter; foley type, three way for continuous irrigation, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"54231","name":"Dynamic cavernosometry","description":"Dynamic cavernosometry, including intracavernosal injection of vasoactive drugs (eg, papaverine, phentolamine)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1427.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0840","name":"Tract frame attach headboard","description":"Traction frame, attached to headboard, cervical traction","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-10","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":"46750","name":"Repair of anal sphincter","description":"Sphincteroplasty, anal, for incontinence or prolapse; adult","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":726.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2520","name":"Contact lens hydrophilic","description":"Contact lens, hydrophilic, spherical, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"E0450","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76390","name":"Mr spectroscopy","description":"Magnetic resonance spectroscopy","date_of_service":"2026-05-10","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":"76380","name":"Cat scan follow-up study","description":"Computed tomography, limited or localized follow-up study","date_of_service":"2026-05-10","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":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27685","name":"Revision of lower leg tendon","description":"Lengthening or shortening of tendon, leg or ankle; single tendon (separate procedure)","date_of_service":"2026-05-10","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":"82331","name":"Calcium infusion test","description":"Calcium; after calcium infusion test","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"90584","name":"Dengue vacc quad 2 dose subq","description":"Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use","date_of_service":"2026-05-10","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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":967.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0463","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92526","name":"Oral function therapy","description":"Treatment of swallowing dysfunction and/or oral function for feeding","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","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":"41252","name":"Repair tongue laceration","description":"Repair of laceration of tongue, floor of mouth, over 2.6 cm or complex","date_of_service":"2026-05-10","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":"87450","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7048","name":"Vacuum drain bottle/tube kit","description":"Vacuum drainage collection unit and tubing kit, including all supplies needed for collection unit change, for use with implanted catheter, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21407","name":"Opn tx orbit fx w/implant","description":"Open treatment of fracture of orbit, except blowout; with implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24400","name":"Osteot humerus w/wo int fixj","description":"Osteotomy, humerus, with or without internal fixation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":993.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"20500","name":"Njx sinus tract therapeutic","description":"Injection of sinus tract; therapeutic (separate procedure)","date_of_service":"2026-05-10","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":"59414","name":"Deliver placenta","description":"Delivery of placenta (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0467","name":"Tlso r fram soft pre ots","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2047.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85420","name":"Fibrinolytic plasminogen","description":"Fibrinolytic factors and inhibitors; plasminogen, except antigenic assay","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96100","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J1438","name":"Etanercept injection","description":"Injection, etanercept, 25 mg (code may be used for medicare when drug administered under the direct supervision of a physician, not for use when drug is self administered)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2587.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"83835","name":"Assay of metanephrines","description":"Metanephrines","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2523.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S8265","name":"Haberman feeder","description":"Haberman feeder for cleft lip/palate","date_of_service":"2026-05-10","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":"21034","name":"Excise max/zygoma mal tumor","description":"Excision of malignant tumor of maxilla or zygoma","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1223","name":"Wheelchair spec size w foot","description":"Wheelchair with detachable arms, footrests","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2829.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","date_of_service":"2026-05-10","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":"L4387","name":"Non-pneum walk boot pre ots","description":"Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1251.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"J2410","name":"Oxymorphone hcl injection","description":"Injection, oxymorphone hcl, up to 1 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78015","name":"Thyroid met imaging","description":"Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78111","name":"Plasma volume multiple","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2341","name":"W/c wdth 24-27 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"29365","name":"Appl cylinder cast","description":"Application of cylinder cast (thigh to ankle)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"G9044","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27100","name":"Transfer of abdominal muscle","description":"Transfer external oblique muscle to greater trochanter including fascial or tendon extension (graft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"92545","name":"Oscillating tracking test","description":"Oscillating tracking test, with recording","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1652","name":"Ho bi thighcuffs w sprdr bar","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","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":"84410","name":"Testosterone bioavailable","description":"Testosterone; bioavailable, direct measurement (eg, differential precipitation)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3671","name":"So cap design w/o jnts cf","description":"Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15811","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":424.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":910.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27430","name":"Revision of thigh muscles","description":"Quadricepsplasty (eg, bennett or thompson type)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":625.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76873","name":"Echograp trans r pros study","description":"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure)","date_of_service":"2026-05-10","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":"86904","name":"Blood typing patient serum","description":"Blood typing, serologic; antigen screening for compatible unit using patient serum, per unit screened","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"23450","name":"Repair shoulder capsule","description":"Capsulorrhaphy, anterior; putti-platt procedure or magnuson type operation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1164.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85610","name":"Prothrombin time","description":"Prothrombin time;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"57230","name":"Repair of urethral lesion","description":"Plastic repair of urethrocele","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":426.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76642","name":"Ultrasound breast limited","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4613","name":"Battery charger","description":"Battery charger; replacement for patient-owned ventilator","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"65770","name":"Keratoprosthesis","description":"Keratoprosthesis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78478","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88160","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; screening and interpretation","date_of_service":"2026-05-10","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":"69300","name":"Revise external ear","description":"Otoplasty, protruding ear, with or without size reduction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":506.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A7523","name":"Tracheostomy shower protect","description":"Tracheostomy shower protector, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78320","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"26442","name":"Release palm & finger tendon","description":"Tenolysis, flexor tendon; palm and finger, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1171.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"55250","name":"Removal of sperm duct(s)","description":"Vasectomy, unilateral or bilateral (separate procedure), including postoperative semen examination(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q0172","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2302","name":"Lens sphere trifocal 7.12-20","description":"Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00, per lens","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"99356","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26641","name":"Treat thumb dislocation","description":"Closed treatment of carpometacarpal dislocation, thumb, with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J1190","name":"Dexrazoxane hcl injection","description":"Injection, dexrazoxane hydrochloride, per 250 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86695","name":"Herpes simplex type 1 test","description":"Antibody; herpes simplex, type 1","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1087","name":"Wheelchair lightwt fixed arm","description":"High strength lightweight wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31613","name":"Tracheostoma revj simple","description":"Tracheostoma revision; simple, without flap rotation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"26542","name":"Repair hand joint with graft","description":"Reconstruction, collateral ligament, metacarpophalangeal joint, single; with local tissue (eg, adductor advancement)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2586.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2175.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87496","name":"Cytomeg dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); cytomegalovirus, amplified probe technique","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44140","name":"Partial removal of colon","description":"Colectomy, partial; with anastomosis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1437.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20910","name":"Remove cartilage for graft","description":"Cartilage graft; costochondral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57410","name":"Pelvic examination","description":"Pelvic examination under anesthesia (other than local)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61450","name":"Crnec stpl sctj cmprn/dcmprn","description":"Craniectomy, subtemporal, for section, compression, or decompression of sensory root of gasserian ganglion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2113.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1401.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23545","name":"Cltx acromclav dislc w/mnpj","description":"Closed treatment of acromioclavicular dislocation; with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83008","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"82735","name":"Assay of fluoride","description":"Fluoride","date_of_service":"2026-05-10","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":"54230","name":"Njx corpora cavernosograpy","description":"Injection procedure for corpora cavernosography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1194.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27594","name":"Amputation follow-up surgery","description":"Amputation, thigh, through femur, any level; secondary closure or scar revision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74300","name":"X-ray bile ducts/pancreas","description":"Cholangiography and/or pancreatography; intraoperative, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"86625","name":"Campylobacter antibody","description":"Antibody; campylobacter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G2063","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"67710","name":"Severing tarsorrhaphy","description":"Severing of tarsorrhaphy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-05-10","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":"V2205","name":"Lens sphcy bifocal 4.00d/4.2","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78206","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7002","name":"Tubing used w suction pump","description":"Tubing, used with suction pump, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-10","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":"90700","name":"Dtap vaccine < 7 yrs im","description":"Diphtheria, tetanus toxoids, and acellular pertussis vaccine (dtap), when administered to individuals younger than 7 years, for intramuscular use","date_of_service":"2026-05-10","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":34.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8320","name":"Truss addition to std pad wa","description":"Truss, addition to standard pad, water pad","date_of_service":"2026-05-10","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":"27767","name":"Cltx post ankle fx","description":"Closed treatment of posterior malleolus fracture; without manipulation","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85009","name":"Manual diff wbc count b-coat","description":"Blood count; manual differential wbc count, buffy coat","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"95973","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1198.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75801","name":"Lymph vessel x-ray arm/leg","description":"Lymphangiography, extremity only, unilateral, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"95829","name":"Surgery electrocorticogram","description":"Electrocorticogram at surgery (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":556.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78006","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L1640","name":"Pelv band/spread bar thigh c","description":"Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"92612","name":"Endoscopy swallow (fees) vid","description":"Flexible endoscopic evaluation of swallowing by cine or video recording;","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","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":"26492","name":"Tendon transfer with graft","description":"Opponensplasty; tendon transfer with graft (includes obtaining graft), each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88300","name":"Surgical path gross","description":"Level i - surgical pathology, gross examination only","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25295","name":"Release wrist/forearm tendon","description":"Tenolysis, flexor or extensor tendon, forearm and/or wrist, single, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43193","name":"Esophagoscp rig trnso biopsy","description":"Esophagoscopy, rigid, transoral; with biopsy, single or multiple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1937.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","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":"86757","name":"Rickettsia antibody","description":"Antibody; rickettsia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0171","name":"Commode chair non-electric","description":"Commode chair with integrated seat lift mechanism, non-electric, any type","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1224","name":"Wheelchair spec size w/ leg","description":"Wheelchair with detachable arms, elevating legrests","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3649","name":"Orthopedic shoe modifica nos","description":"Orthopedic shoe, modification, addition or transfer, not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27181","name":"Treat slipped epiphysis","description":"Open treatment of slipped femoral epiphysis; osteotomy and internal fixation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78231","name":"Salivary glnd img serial img","description":"Salivary gland imaging; with serial images","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"A6258","name":"Transparent film >16<=48 in","description":"Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":646.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2036","name":"Kafo plas doub free knee mol","description":"Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2794.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85305","name":"Clot inhibit prot s total","description":"Clotting inhibitors or anticoagulants; protein s, total","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"67850","name":"Dstrj lesion lid margin <1cm","description":"Destruction of lesion of lid margin (up to 1 cm)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35661","name":"Bpg femoral-femoral","description":"Bypass graft, with other than vein; femoral-femoral","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5980","name":"Flex foot system","description":"All lower extremity prostheses, flex foot system","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4014","name":"Cast sup gauntlet fiberglass","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"21196","name":"Reconst lwr jaw w/fixation","description":"Reconstruction of mandibular rami and/or body, sagittal split; with internal rigid fixation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1151.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"99185","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":829.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33617","name":"Repair single ventricle","description":"Repair of complex cardiac anomalies (eg, single ventricle) by modified fontan procedure","date_of_service":"2026-05-10","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":"93701","name":"Bioimpedance cv analysis","description":"Bioimpedance-derived physiologic cardiovascular analysis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91022","name":"Duodenal motility study","description":"Duodenal motility (manometric) study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72126","name":"Ct neck spine w/dye","description":"Computed tomography, cervical spine; with contrast material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77011","name":"Ct scan for localization","description":"Computed tomography guidance for stereotactic localization","date_of_service":"2026-05-10","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":"93602","name":"Intra-atrial recording","description":"Intra-atrial recording","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3981","name":"Ue fx orth shoul cap forearm","description":"Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5430","name":"Postop dsg ak ea add cast ch","description":"Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, ak or knee disarticulation, each additional cast change and realignment","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":747.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21825","name":"Treat sternum fracture","description":"Open treatment of sternum fracture with or without skeletal fixation","date_of_service":"2026-05-10","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":"33300","name":"Repair of heart wound","description":"Repair of cardiac wound; without bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1334.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"36516","name":"Apheresis immunoads slctv","description":"Therapeutic apheresis; with extracorporeal immunoadsorption, selective adsorption or selective filtration and plasma reinfusion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"76529","name":"Echo exam of eye","description":"Ophthalmic ultrasonic foreign body localization","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"P9016","name":"Rbc leukocytes reduced","description":"Red blood cells, leukocytes reduced, each unit","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82520","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"53510","name":"Repair of urethra injury","description":"Urethrorrhaphy, suture of urethral wound or injury; perineal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":510.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":815.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2114","name":"Afo tib fx semi-rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","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":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":"76098","name":"X-ray exam surgical specimen","description":"Radiological examination, surgical specimen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A6266","name":"Impreg gauze no h20/sal/yard","description":"Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71090","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"G6009","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96523","name":"Irrig drug delivery device","description":"Irrigation of implanted venous access device for drug delivery systems","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2005","name":"Kafo sng/dbl mechanical act","description":"Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated","date_of_service":"2026-05-10","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":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6676","name":"Harness figure of 8 dual con","description":"Upper extremity addition, harness, (e.g., figure of eight type), dual cable design","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"72080","name":"X-ray exam thoracolmb 2/> vw","description":"Radiologic examination, spine; thoracolumbar junction, minimum of 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95913","name":"Nrv cndj test 13/> studies","description":"Nerve conduction studies; 13 or more studies","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54205","name":"Njx px peyronie ds exps plaq","description":"Injection procedure for peyronie disease; with surgical exposure of plaque","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4215","name":"Sterile needle","description":"Needle, sterile, any size, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"29888","name":"Arthrs aid acl rpr/agmntj","description":"Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction","date_of_service":"2026-05-10","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":"82154","name":"Androstanediol glucuronide","description":"Androstanediol glucuronide","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5624","name":"Test socket above knee","description":"Addition to lower extremity, test socket, above knee","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-10","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":"A4602","name":"Replace lithium battery 1.5v","description":"Replacement battery for external infusion pump owned by patient, lithium, 1.5 volt, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J7350","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84081","name":"Assay phosphatidylglycerol","description":"Phosphatidylglycerol","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"54015","name":"I&d penis deep","description":"Incision and drainage of penis, deep","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":618.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6565","name":"Grad comp gauntlet custom","description":"Gradient compression gauntlet, custom, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6965","name":"Shldr disartic myoelectronic","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36430","name":"Transfusion bld/bld compnt","description":"Transfusion, blood or blood components","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1062.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"71035","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["MS"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78606","name":"Brain image w/flow 4 + views","description":"Brain imaging, minimum 4 static views; with vascular flow","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"46938","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1308.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"01842","name":"Anes art farm wrst&hnd emblc","description":"Anesthesia for procedures on arteries of forearm, wrist, and hand; embolectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"S3819","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93602","name":"Intra-atrial recording","description":"Intra-atrial recording","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0501","name":"Shwr cov elec/combo vad, rep","description":"Shower cover for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"32661","name":"Thoracoscopy w/pericard exc","description":"Thoracoscopy, surgical; with excision of pericardial cyst, tumor, or mass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1028.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"60271","name":"Removal of thyroid","description":"Thyroidectomy, including substernal thyroid; cervical approach","date_of_service":"2026-05-10","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":"93930","name":"Upper extremity study","description":"Duplex scan of upper extremity arteries or arterial bypass grafts; complete bilateral study","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","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":"38571","name":"Laparoscopy lymphadenectomy","description":"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy","date_of_service":"2026-05-10","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":"76391","name":"Mr elastography","description":"Magnetic resonance (eg, vibration) elastography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77762","name":"Apply intrcav radiat interm","description":"Intracavitary radiation source application; intermediate","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78120","name":"Red cell mass single","description":"Red cell volume determination (separate procedure); single sampling","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27766","name":"Optx medial ankle fx","description":"Open treatment of medial malleolus fracture, includes internal fixation, when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"51795","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"90815","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"87185","name":"Sc std enzyme detcj per nzm","description":"Susceptibility studies, antimicrobial agent; enzyme detection (eg, beta lactamase), per enzyme","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"21615","name":"Excision 1st &/cervical rib","description":"Excision first and/or cervical rib;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L3967","name":"Sewho airplane w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00216","name":"Anes icr px vascular px","description":"Anesthesia for intracranial procedures; vascular procedures","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":364.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49419","name":"Insert tun ip cath w/port","description":"Insertion of tunneled intraperitoneal catheter, with subcutaneous port (ie, totally implantable)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1682.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KF"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"25491","name":"Prophylactic tx ulna","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; ulna","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","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":"51865","name":"Repair of bladder wound","description":"Cystorrhaphy, suture of bladder wound, injury or rupture; complicated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":736.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1990","name":"Afo doub solid stirrup calf","description":"Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar bk orthosis), custom fabricated","date_of_service":"2026-05-10","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":"74742","name":"X-ray fallopian tube","description":"Transcervical catheterization of fallopian tube, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77761","name":"Apply intrcav radiat simple","description":"Intracavitary radiation source application; simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78582","name":"Lung ventilat&perfus imaging","description":"Pulmonary ventilation (eg, aerosol or gas) and perfusion imaging","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57210","name":"Repair vagina/perineum","description":"Colpoperineorrhaphy, suture of injury of vagina and/or perineum (nonobstetrical)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47370","name":"Laparo ablate liver tumor rf","description":"Laparoscopy, surgical, ablation of 1 or more liver tumor(s); radiofrequency","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1346.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7026","name":"Replace chst cmprss sys hose","description":"High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each","date_of_service":"2026-05-10","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":"59025","name":"Fetal non-stress test","description":"Fetal non-stress test","date_of_service":"2026-05-10","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":"92130","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62365","name":"Remove spine infusion device","description":"Removal of subcutaneous reservoir or pump, previously implanted for intrathecal or epidural infusion","date_of_service":"2026-05-10","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":"E1222","name":"Wheelchair spec size w/ leg","description":"Wheelchair with fixed arm, elevating legrests","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0135","name":"Walker folding adjust/fixed","description":"Walker, folding (pickup), adjustable or fixed height","date_of_service":"2026-05-10","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":"48153","name":"Pancreatectomy","description":"Pancreatectomy, proximal subtotal with near-total duodenectomy, choledochoenterostomy and duodenojejunostomy (pylorus-sparing, whipple-type procedure); with pancreatojejunostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3281.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":917.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72192","name":"Ct pelvis w/o dye","description":"Computed tomography, pelvis; without contrast material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20251","name":"Biopsy vrt bdy open lmbr/crv","description":"Biopsy, vertebral body, open; lumbar or cervical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74455","name":"X-ray urethra/bladder","description":"Urethrocystography, voiding, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27605","name":"Incision of achilles tendon","description":"Tenotomy, percutaneous, achilles tendon (separate procedure); local anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8300","name":"Truss single w/ standard pad","description":"Truss, single with standard pad","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2390","name":"Solid drive wheel tire","description":"Power wheelchair accessory, solid (rubber/plastic) drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"72170","name":"X-ray exam of pelvis","description":"Radiologic examination, pelvis; 1 or 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"25136","name":"Remove & graft wrist lesion","description":"Excision or curettage of bone cyst or benign tumor of carpal bones; with allograft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":625.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"26130","name":"Remove wrist joint lining","description":"Synovectomy, carpometacarpal joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2625","name":"Enlargemnt of eye prosthesis","description":"Enlargement of ocular prosthesis","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3252","name":"Shoe molded plastazote cust","description":"Foot, shoe molded to patient model, plastazote (or similar), custom fabricated, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","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":"57311","name":"Repair urethrovaginal lesion","description":"Closure of urethrovaginal fistula; with bulbocavernosus transplant","date_of_service":"2026-05-10","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":"36450","name":"Bld exchange truj newborn","description":"Exchange transfusion, blood; newborn","date_of_service":"2026-05-10","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":"27443","name":"Revision of knee joint","description":"Arthroplasty, femoral condyles or tibial plateau(s), knee; with debridement and partial synovectomy","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85705","name":"Thromboplastin inhibition","description":"Thromboplastin inhibition, tissue","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q0506","name":"Lith-ion batt elec/pneum vad","description":"Battery, lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33861","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2945.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1087","name":"Wheelchair lightwt fixed arm","description":"High strength lightweight wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01960","name":"Anes vaginal delivery only","description":"Anesthesia for vaginal delivery only","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":906.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"28202","name":"Repair/graft of foot tendon","description":"Repair, tendon, flexor, foot; secondary with free graft, each tendon (includes obtaining graft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KC"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1038","name":"Transport chair pt wt<=300lb","description":"Transport chair, adult size, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6689","name":"Frame typ socket shoulder di","description":"Upper extremity addition, frame type socket, shoulder disarticulation","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4351","name":"Straight tip urine catheter","description":"Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"72265","name":"Myelography l-s spine","description":"Myelography, lumbosacral, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"85651","name":"Rbc sed rate nonautomated","description":"Sedimentation rate, erythrocyte; non-automated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L5301","name":"Bk mold socket sach ft endo","description":"Below knee, molded socket, shin, sach foot, endoskeletal system","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"19290","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29015","name":"Appl rissr jacket bdy w/head","description":"Application of risser jacket, localizer, body; including head","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":295.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"V2522","name":"Cntct lens hydrophil bifocl","description":"Contact lens, hydrophilic, bifocal, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["TC"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1223.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61440","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":889.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J2513","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"76817","name":"Transvaginal us obstetric","description":"Ultrasound, pregnant uterus, real time with image documentation, transvaginal","date_of_service":"2026-05-10","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":"50525","name":"Close nephrovisceral fistula","description":"Closure of nephrovisceral fistula (eg, renocolic), including visceral repair; abdominal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"ATP08","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90846","name":"Family psytx w/o pt 50 min","description":"Family psychotherapy (without the patient present), 50 minutes","date_of_service":"2026-05-10","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":"33681","name":"Closure 1 vsd w/wo patch","description":"Closure of single ventricular septal defect, with or without patch;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2228.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"76820","name":"Umbilical artery echo","description":"Doppler velocimetry, fetal; umbilical artery","date_of_service":"2026-05-10","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":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"42808","name":"Excise pharynx lesion","description":"Excision or destruction of lesion of pharynx, any method","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35571","name":"Art byp pop-tibl-prl-other","description":"Bypass graft, with vein; popliteal-tibial, -peroneal artery or other distal vessels","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1714.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27252","name":"Treat hip dislocation","description":"Closed treatment of hip dislocation, traumatic; requiring anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20824","name":"Replantation thumb complete","description":"Replantation, thumb (includes carpometacarpal joint to mp joint), complete amputation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3303.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1980","name":"Afo sing solid stirrup calf","description":"Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar bk orthosis), custom fabricated","date_of_service":"2026-05-10","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":"75736","name":"Artery x-rays pelvis","description":"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"82550","name":"Assay of ck (cpk)","description":"Creatine kinase (ck), (cpk); total","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G0517","name":"Remove drug implant","description":"Removal of non-biodegradable drug delivery implants, 4 or more (services for subdermal implants)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1072.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":837.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71034","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"95819","name":"Eeg awake and asleep","description":"Electroencephalogram (eeg); including recording awake and asleep","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67105","name":"Repair detached retina pc","description":"Repair of retinal detachment, including drainage of subretinal fluid when performed; photocoagulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84075","name":"Assay alkaline phosphatase","description":"Phosphatase, alkaline;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J9291","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1095.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4428","name":"Urine ost pouch w faucet/tap","description":"Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":850.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":625.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0560","name":"Humidifier supplemental w/ i","description":"Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2342.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1022.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"G0168","name":"Wound closure by adhesive","description":"Wound closure utilizing tissue adhesive(s) only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51020","name":"Cystotomy/cystostomy w/fulg","description":"Cystotomy or cystostomy, with fulguration and/or insertion of radioactive material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2030","name":"Kafo dbl solid stirrup w/o j","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar ak orthosis), without knee joint, custom fabricated","date_of_service":"2026-05-10","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":"23101","name":"Arthrt acrmclv/strnclav jt","description":"Arthrotomy, acromioclavicular joint or sternoclavicular joint, including biopsy and/or excision of torn cartilage","date_of_service":"2026-05-10","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":"67115","name":"Release encircling material","description":"Release of encircling material (posterior segment)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":460.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1661.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"77261","name":"Ther radiology tx plng smpl","description":"Therapeutic radiology treatment planning; simple","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L8619","name":"Coch imp ext proc/contr rplc","description":"Cochlear implant, external speech processor and controller, integrated system, replacement","date_of_service":"2026-05-10","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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-10","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":"51020","name":"Cystotomy/cystostomy w/fulg","description":"Cystotomy or cystostomy, with fulguration and/or insertion of radioactive material","date_of_service":"2026-05-10","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":"46030","name":"Removal anal seton oth mrk","description":"Removal of anal seton, other marker","date_of_service":"2026-05-10","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":"35665","name":"Bpg iliofemoral","description":"Bypass graft, with other than vein; iliofemoral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1033.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-10","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":"E2341","name":"W/c wdth 24-27 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-10","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":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5812","name":"Endo knee-shin frct swg & st","description":"Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77058","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1411.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"34501","name":"Repair valve femoral vein","description":"Valvuloplasty, femoral vein","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":714.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93886","name":"Intracranial complete study","description":"Transcranial doppler study of the intracranial arteries; complete study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94726","name":"Plethysmography lung volumes","description":"Plethysmography for determination of lung volumes and, when performed, airway resistance","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"20501","name":"Njx sinus tract diagnostic","description":"Injection of sinus tract; diagnostic (sinogram)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":428.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"89225","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"75790","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"94750","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94772","name":"Circadian respir pattern rec","description":"Circadian respiratory pattern recording (pediatric pneumogram), 12-24 hour continuous recording, infant","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"92545","name":"Oscillating tracking test","description":"Oscillating tracking test, with recording","date_of_service":"2026-05-10","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":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73701","name":"Ct lower extremity w/dye","description":"Computed tomography, lower extremity; with contrast material(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43124","name":"Removal of esophagus","description":"Total or partial esophagectomy, without reconstruction (any approach), with cervical esophagostomy","date_of_service":"2026-05-10","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":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27267","name":"Cltx thigh fx","description":"Closed treatment of femoral fracture, proximal end, head; without manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23505","name":"Cltx clavicular fx w/mnpj","description":"Closed treatment of clavicular fracture; with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J3120","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78006","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2209","name":"Lens sphcy bifocal 4.25-7/4.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"39540","name":"Repair of diaphragm hernia","description":"Repair, diaphragmatic hernia (other than neonatal), traumatic; acute","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"43264","name":"Ercp remove duct calculi","description":"Endoscopic retrograde cholangiopancreatography (ercp); with removal of calculi/debris from biliary/pancreatic duct(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00300","name":"Anes all px integ h/n/ptrunk","description":"Anesthesia for all procedures on the integumentary system, muscles and nerves of head, neck, and posterior trunk, not otherwise specified","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4481","name":"Tracheostoma filter","description":"Tracheostoma filter, any type, any size, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"68362","name":"Revise eyelid lining","description":"Conjunctival flap; total (such as gunderson thin flap or purse string flap)","date_of_service":"2026-05-10","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":"G0357","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":837.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71048","name":"X-ray exam chest 4+ views","description":"Radiologic examination, chest; 4 or more views","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"34490","name":"Removal of vein clot","description":"Thrombectomy, direct or with catheter; axillary and subclavian vein, by arm incision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":745.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2070","name":"Hkafo torsion unilat rot str","description":"Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27111","name":"Transfer of iliopsoas muscle","description":"Transfer iliopsoas; to femoral neck","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1055.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1323.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32320","name":"Free/remove chest lining","description":"Decortication and parietal pleurectomy","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25031","name":"I&d forearm&/wrist bursa","description":"Incision and drainage, forearm and/or wrist; bursa","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"56405","name":"I&d vulva/perineal abscess","description":"Incision and drainage of vulva or perineal abscess","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"50546","name":"Laparoscopic nephrectomy","description":"Laparoscopy, surgical; nephrectomy, including partial ureterectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3972","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"G0206","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E0217","name":"Water circ heat pad w pump","description":"Water circulating heat pad with pump","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"87533","name":"Hhv-6 dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); herpes virus-6, quantification","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"J0500","name":"Dicyclomine injection","description":"Injection, dicyclomine hcl, up to 20 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21450","name":"Cltx mndblr fx w/o mnpj","description":"Closed treatment of mandibular fracture; without manipulation","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1478.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"E1031","name":"Rollabout chair with casters","description":"Rollabout chair, any and all types with casters 5 or greater","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"11102","name":"Tangntl bx skin single les","description":"Tangential biopsy of skin (eg, shave, scoop, saucerize, curette); single lesion","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2993.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76986","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00222","name":"Anes icr px ecoag icr nrv","description":"Anesthesia for intracranial procedures; electrocoagulation of intracranial nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"29820","name":"Sho arthrs srg prtl synvct","description":"Arthroscopy, shoulder, surgical; synovectomy, partial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":663.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2320","name":"Non-molded lacer","description":"Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J9250","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92560","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"A4234","name":"J-cell batt for glucose mon","description":"Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5814","name":"Endo knee-shin hydral swg ph","description":"Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L3673","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2250","name":"Foot plate molded stirrup at","description":"Addition to lower extremity, foot plate, molded to patient model, stirrup attachment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"65222","name":"Remove foreign body from eye","description":"Removal of foreign body, external eye; corneal, with slit lamp","date_of_service":"2026-05-10","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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1222","name":"Wheelchair spec size w/ leg","description":"Wheelchair with fixed arm, elevating legrests","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"L3201","name":"Oxford w supinat/pronat inf","description":"Orthopedic shoe, oxford with supinator or pronator, infant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0440T","name":"Abltj perc uxtr/perph nrv","description":"Ablation, percutaneous, cryoablation, includes imaging guidance; upper extremity distal/peripheral nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42227","name":"Lengthening of palate","description":"Lengthening of palate, with island flap","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73201","name":"Ct upper extremity w/dye","description":"Computed tomography, upper extremity; with contrast material(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28072","name":"Removal of foot joint lining","description":"Synovectomy; metatarsophalangeal joint, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-10","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":"37145","name":"Revision of circulation","description":"Venous anastomosis, open; renoportal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3933","name":"Fo w/o joints cf","description":"Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1362.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77072","name":"Bone age studies","description":"Bone age studies","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":947.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"67316","name":"Revise two eye muscles","description":"Strabismus surgery, recession or resection procedure; 2 or more vertical muscles (excluding superior oblique)","date_of_service":"2026-05-10","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":"00790","name":"Anes iper upr abd nos","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; not otherwise specified","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99294","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88241","name":"Frozen cell preparation","description":"Thawing and expansion of frozen cells, each aliquot","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19367","name":"Brst rcnstj 1 pdcl tram flap","description":"Breast reconstruction; with single-pedicled transverse rectus abdominis myocutaneous (tram) flap","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2099.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3933","name":"Fo w/o joints cf","description":"Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":"75731","name":"Artery x-rays adrenal gland","description":"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"27707","name":"Osteotomy fibula","description":"Osteotomy; fibula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78832","name":"Rp loclzj tum spect w/ct 2","description":"Radiopharmaceutical localization of tumor, inflammatory process or distribution of radiopharmaceutical agent(s) (includes vascular flow and blood pool imaging, when performed); tomographic (spect) with concurrently acquired computed tomography (ct) transmission scan for anatomical review, localizati","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74020","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-10","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":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":705.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"68700","name":"Repair tear ducts","description":"Plastic repair of canaliculi","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"26255","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":649.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99432","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"76998","name":"Us guide intraop","description":"Ultrasonic guidance, intraoperative","date_of_service":"2026-05-10","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":"G0389","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"73501","name":"X-ray exam hip uni 1 view","description":"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83864","name":"Mucopolysaccharides","description":"Mucopolysaccharides, acid, quantitative","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63744","name":"Revision of spinal shunt","description":"Replacement, irrigation or revision of lumbosubarachnoid shunt","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"53220","name":"Treatment of urethra lesion","description":"Excision or fulguration of carcinoma of urethra","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1850","name":"Ko swedish type pre ots","description":"Knee orthosis, swedish type, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":"73525","name":"Contrast x-ray of hip","description":"Radiologic examination, hip, arthrography, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84100","name":"Assay of phosphorus","description":"Phosphorus inorganic (phosphate);","date_of_service":"2026-05-10","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":"43501","name":"Surgical repair of stomach","description":"Gastrotomy; with suture repair of bleeding ulcer","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1379.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91122","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"A4262","name":"Temporary tear duct plug","description":"Temporary, absorbable lacrimal duct implant, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46760","name":"Repair of anal sphincter","description":"Sphincteroplasty, anal, for incontinence, adult; muscle transplant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":851.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0639","name":"Lso s/c shell/panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4377","name":"Drainable plstic pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, plastic, each","date_of_service":"2026-05-10","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":"64742","name":"Incision of facial nerve","description":"Transection or avulsion of; facial nerve, differential or complete","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":524.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":574.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"T5001","name":"Position seat spec orth need","description":"Positioning seat for persons with special orthopedic needs","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76102","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","date_of_service":"2026-05-10","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":"L3966","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"40527","name":"Reconstruct lip with flap","description":"Excision of lip; full thickness, reconstruction with cross lip flap (abbe-estlander)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82525","name":"Assay of copper","description":"Copper","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"00550","name":"Anes for sternal debridement","description":"Anesthesia for sternal debridement","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L6029","name":"Test interface part handfing","description":"Upper extremity addition, test socket/interface, partial hand including fingers","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0183","name":"Press underlay alter w/pump","description":"Powered pressure reducing underlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4409","name":"Ost skn barr convex <=4 sq i","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"43641","name":"Vagotomy & pylorus repair","description":"Vagotomy including pyloroplasty, with or without gastrostomy; parietal cell (highly selective)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"75968","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27430","name":"Revision of thigh muscles","description":"Quadricepsplasty (eg, bennett or thompson type)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4269","name":"Spermicide","description":"Contraceptive supply, spermicide (e.g., foam, gel), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"78320","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"11950","name":"Subq njx filling matrl 1cc/<","description":"Subcutaneous injection of filling material (eg, collagen); 1 cc or less","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"J0285","name":"Amphotericin b","description":"Injection, amphotericin b, 50 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E0984","name":"Add pwr tiller","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":769.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99311","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35531","name":"Art byp grft aorcel/aormesen","description":"Bypass graft, with vein; aortoceliac or aortomesenteric","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1723.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":234.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43634","name":"Removal of stomach partial","description":"Gastrectomy, partial, distal; with formation of intestinal pouch","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"L8010","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95861","name":"Needle emg 2 extremities","description":"Needle electromyography; 2 extremities with or without related paraspinal areas","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1316.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6568","name":"G com garment torso/shldr","description":"Gradient compression garment, torso and shoulder, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95827","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E0445","name":"Oximeter non-invasive","description":"Oximeter device for measuring blood oxygen levels non-invasively","date_of_service":"2026-05-10","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":"G6014","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"A7018","name":"Water distilled w/nebulizer","description":"Water, distilled, used with large volume nebulizer, 1000 ml","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L2627","name":"Plastic mold recipro hip & c","description":"Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"55550","name":"Laparo ligate spermatic vein","description":"Laparoscopy, surgical, with ligation of spermatic veins for varicocele","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24151","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1351.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51736","name":"Urine flow measurement","description":"Simple uroflowmetry (ufr) (eg, stop-watch flow rate, mechanical uroflowmeter)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0607","name":"Repl batt for aed","description":"Replacement battery for automated external defibrillator, garment type only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"21196","name":"Reconst lwr jaw w/fixation","description":"Reconstruction of mandibular rami and/or body, sagittal split; with internal rigid fixation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1650.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64650","name":"Chemodenerv eccrine glands","description":"Chemodenervation of eccrine glands; both axillae","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58555","name":"Hysteroscopy dx sep proc","description":"Hysteroscopy, diagnostic (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32096","name":"Open wedge/bx lung infiltr","description":"Thoracotomy, with diagnostic biopsy(ies) of lung infiltrate(s) (eg, wedge, incisional), unilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"78270","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80185","name":"Assay of phenytoin total","description":"Phenytoin; total","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"J7513","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"23920","name":"Disarticulation shoulder","description":"Disarticulation of shoulder;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1221.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33513","name":"Cabg vein four","description":"Coronary artery bypass, vein only; 4 coronary venous grafts","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2449.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"64792","name":"Removal of nerve lesion","description":"Excision of neurofibroma or neurolemmoma; extensive (including malignant type)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"68770","name":"Close tear system fistula","description":"Closure of lacrimal fistula (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1028.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6221","name":"Gauze > 48 sq in w/border","description":"Gauze, non-impregnated, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-10","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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"75953","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-10","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":"L6025","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3897.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70240","name":"X-ray exam pituitary saddle","description":"Radiologic examination, sella turcica","date_of_service":"2026-05-10","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":"75741","name":"Artery x-rays lung","description":"Angiography, pulmonary, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0291","name":"Hosp bed fx ht w/o rail w/o","description":"Hospital bed, fixed height, without side rails, without mattress","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":994.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"51100","name":"Drain bladder by needle","description":"Aspiration of bladder; by needle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"ATP06","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21406","name":"Opn tx orbit fx w/o implant","description":"Open treatment of fracture of orbit, except blowout; without implant","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7035","name":"Pos airway press headgear","description":"Headgear used with positive airway pressure device","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":965.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"42405","name":"Biopsy of salivary gland","description":"Biopsy of salivary gland; incisional","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20206","name":"Biopsy muscle perq needle","description":"Biopsy, muscle, percutaneous needle","date_of_service":"2026-05-10","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":"51992","name":"Laparo sling operation","description":"Laparoscopy, surgical; sling operation for stress incontinence (eg, fascia or synthetic)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":954.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"78232","name":"Salivary gland function std","description":"Salivary gland function study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"53080","name":"Drainage of urinary leakage","description":"Drainage of perineal urinary extravasation; uncomplicated (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":572.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":"G0434","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L4394","name":"Replace foot drop spint","description":"Replace soft interface material, foot drop splint","date_of_service":"2026-05-10","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":"58740","name":"Adhesiolysis tube ovary","description":"Lysis of adhesions (salpingolysis, ovariolysis)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00537","name":"Anes cardiac ep procedures","description":"Anesthesia for cardiac electrophysiologic procedures including radiofrequency ablation","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42220","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate; secondary lengthening procedure","date_of_service":"2026-05-10","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":"78201","name":"Liver imaging static only","description":"Liver imaging; static only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1160.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"74485","name":"Dilation urtr/urt rs&i","description":"Dilation of ureter(s) or urethra, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44137","name":"Remove intestinal allograft","description":"Removal of transplanted intestinal allograft, complete","date_of_service":"2026-05-10","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":"E1195","name":"Wheelchair amputee heavy dut","description":"Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L0635","name":"Lso sagit rigid panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pr","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59151","name":"Treat ectopic pregnancy","description":"Laparoscopic treatment of ectopic pregnancy; with salpingectomy and/or oophorectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":680.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0202","name":"Phototherapy light w/ photom","description":"Phototherapy (bilirubin) light with photometer","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":838.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5665","name":"Multi-durometer below knee","description":"Addition to lower extremity, socket insert, multi-durometer, below knee","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27454","name":"Realignment of thigh bone","description":"Osteotomy, multiple, with realignment on intramedullary rod, femoral shaft (eg, sofield type procedure)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"E1372","name":"Oxy suppl heater for nebuliz","description":"Immersion external heater for nebulizer","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3115.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51741","name":"Electro-uroflowmetry first","description":"Complex uroflowmetry (eg, calibrated electronic equipment)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61490","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"G2065","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77077","name":"Joint survey single view","description":"Joint survey, single view, 2 or more joints (specify)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6410","name":"Sterile eye pad","description":"Eye pad, sterile, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"Q0493","name":"Emr pwr cbl combo vad, rep","description":"Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"54250","name":"Nctrnl pen tmscn&/rgdity tst","description":"Nocturnal penile tumescence and/or rigidity test","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1188.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"65273","name":"Repair of eye wound","description":"Repair of laceration; conjunctiva, by mobilization and rearrangement, with hospitalization","date_of_service":"2026-05-10","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":"38115","name":"Repair of ruptured spleen","description":"Repair of ruptured spleen (splenorrhaphy) with or without partial splenectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1088.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":464.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"34825","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":588.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92512","name":"Nasal function studies","description":"Nasal function studies (eg, rhinomanometry)","date_of_service":"2026-05-10","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":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1437.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0737","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25660","name":"Cltx rdcrpl/ntrcrpl dislc 1+","description":"Closed treatment of radiocarpal or intercarpal dislocation, 1 or more bones, with manipulation","date_of_service":"2026-05-10","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":"31084","name":"Removal of frontal sinus","description":"Sinusotomy frontal; obliterative, with osteoplastic flap, brow incision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1274.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L7009","name":"Adult electric hook","description":"Electric hook, switch or myoelectric controlled, adult","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"25444","name":"Arthrp w/prostc lunate","description":"Arthroplasty with prosthetic replacement; lunate","date_of_service":"2026-05-10","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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1123.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":763.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58953","name":"Tah rad dissect for debulk","description":"Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical dissection for debulking;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6216","name":"Non-sterile gauze<=16 sq in","description":"Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-05-10","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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78580","name":"Lung perfusion imaging","description":"Pulmonary perfusion imaging (eg, particulate)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8417","name":"Pros sheath/sock w gel cushn","description":"Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"27656","name":"Repair leg fascia defect","description":"Repair, fascial defect of leg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"92981","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J0540","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2087.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"85611","name":"Prothrombin test","description":"Prothrombin time; substitution, plasma fractions, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74305","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1730","name":"Legg perthes orth scottish r","description":"Legg perthes orthosis, (scottish rite type), custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"70460","name":"Ct head/brain w/dye","description":"Computed tomography, head or brain; with contrast material(s)","date_of_service":"2026-05-10","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":"28052","name":"Biopsy of foot joint lining","description":"Arthrotomy with biopsy; metatarsophalangeal joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":"V2201","name":"Lens sphere bifocal 4.12-7.0","description":"Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"42260","name":"Repair nose to lip fistula","description":"Repair of nasolabial fistula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0468","name":"Home vent dual fnct incl all","description":"Home ventilator, dual-function respiratory device, also performs additional function of cough stimulation, includes all accessories, components and supplies for all functions","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"44403","name":"Colonoscopy w/resection","description":"Colonoscopy through stoma; with endoscopic mucosal resection","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"59020","name":"Fetal contract stress test","description":"Fetal contraction stress test","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32400","name":"Needle biopsy chest lining","description":"Biopsy, pleura, percutaneous needle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0490","name":"Tlso rigid plastic pre one","description":"Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, res","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"00922","name":"Anes px male gent sem ves","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); seminal vesicles","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"G0430","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"27381","name":"Repair/graft kneecap tendon","description":"Suture of infrapatellar tendon; secondary reconstruction, including fascial or tendon graft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":969.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1325","name":"Epoprostenol injection","description":"Injection, epoprostenol, 0.5 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77285","name":"Ther rad simulaj field intrm","description":"Therapeutic radiology simulation-aided field setting; intermediate","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85360","name":"Euglobulin lysis","description":"Euglobulin lysis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31531","name":"Laryngoscopy w/fb & op scope","description":"Laryngoscopy, direct, operative, with foreign body removal; with operating microscope or telescope","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1347.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9060","name":"Cisplatin 10 mg injection","description":"Injection, cisplatin, powder or solution, 10 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3976","name":"Sewhfo airplane w/o jnts cf","description":"Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6200","name":"Elbow mold outsid lock hinge","description":"Elbow disarticulation, molded socket, outside locking hinge, forearm","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35400","name":"Angioscopy","description":"Angioscopy (noncoronary vessels or grafts) during therapeutic intervention (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2240","name":"Round caliper and plate atta","description":"Addition to lower extremity, round caliper and plate attachment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33800","name":"Aortic suspension","description":"Aortic suspension (aortopexy) for tracheal decompression (eg, for tracheomalacia) (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1205.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"32602","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"55300","name":"Prepare sperm duct x-ray","description":"Vasotomy for vasograms, seminal vesiculograms, or epididymograms, unilateral or bilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84146","name":"Assay of prolactin","description":"Prolactin","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53260","name":"Treatment of urethra lesion","description":"Excision or fulguration; urethral polyp(s), distal urethra","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A5062","name":"Drnble ostomy pouch w/o barr","description":"Ostomy pouch, drainable; without barrier attached (1 piece), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"50727","name":"Revise ureter","description":"Revision of urinary-cutaneous anastomosis (any type urostomy);","date_of_service":"2026-05-10","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":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"27427","name":"Reconstruction knee","description":"Ligamentous reconstruction (augmentation), knee; extra-articular","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"V2214","name":"Lens sphcyl bifocal over 12.","description":"Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1223.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1820","name":"Ko elas w/ condyle pads & jo","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"25651","name":"Perq skel fix ulnar styld fx","description":"Percutaneous skeletal fixation of ulnar styloid fracture","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69222","name":"Clean out mastoid cavity","description":"Debridement, mastoidectomy cavity, complex (eg, with anesthesia or more than routine cleaning)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"01965","name":"Anes incompl/missed ab px","description":"Anesthesia for incomplete or missed abortion procedures","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53600","name":"Dilate urethra stricture","description":"Dilation of urethral stricture by passage of sound or urethral dilator, male; initial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27665","name":"Repair of leg tendon each","description":"Repair, extensor tendon, leg; secondary, with or without graft, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-10","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":"93526","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85041","name":"Automated rbc count","description":"Blood count; red blood cell (rbc), automated","date_of_service":"2026-05-10","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":"92597","name":"Oral speech device eval","description":"Evaluation for use and/or fitting of voice prosthetic device to supplement oral speech","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6520","name":"G com garmnt glove nghttime","description":"Gradient compression garment, glove, padded, for nighttime use, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"29126","name":"Appl short arm splint dyn","description":"Application of short arm splint (forearm to hand); dynamic","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"51795","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3973","name":"Sewho airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.16,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"67875","name":"Closure of eyelid by suture","description":"Temporary closure of eyelids by suture (eg, frost suture)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78272","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2730","name":"Special base curve","description":"Special base curve, glass or plastic, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":604.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"E0200","name":"Heat lamp without stand","description":"Heat lamp, without stand (table model), includes bulb, or infrared element","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92614","name":"Laryngoscopic sensory vid","description":"Flexible endoscopic evaluation, laryngeal sensory testing by cine or video recording;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84379","name":"Sugars multiple quant","description":"Sugars (mono-, di-, and oligosaccharides); multiple quantitative, each specimen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82492","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"44151","name":"Removal of colon/ileostomy","description":"Colectomy, total, abdominal, without proctectomy; with continent ileostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1807.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1725","name":"Cath, translumin non-laser","description":"Catheter, transluminal angioplasty, non-laser (may include guidance, infusion/perfusion capability)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":364.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":856.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26562","name":"Repair of web finger","description":"Repair of syndactyly (web finger) each web space; complex (eg, involving bone, nails)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72193","name":"Ct pelvis w/dye","description":"Computed tomography, pelvis; with contrast material(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32036","name":"Thoracostomy w/flap drainage","description":"Thoracostomy; with open flap drainage for empyema","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84132","name":"Assay of serum potassium","description":"Potassium; serum, plasma or whole blood","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"92597","name":"Oral speech device eval","description":"Evaluation for use and/or fitting of voice prosthetic device to supplement oral speech","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6586","name":"Grad com wrap w strap fu leg","description":"Gradient compression wrap with adjustable straps, full leg, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2038","name":"Kafo w/o joint multi-axis an","description":"Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5845","name":"Knee-shin sys stance flexion","description":"Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable","date_of_service":"2026-05-10","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":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"68130","name":"Exc les conjunctiva adj scl","description":"Excision of lesion, conjunctiva; with adjacent sclera","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1263.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0462","name":"Rocking bed w/ or w/o side r","description":"Rocking bed with or without side rails","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91100","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"32852","name":"Lung transplant with bypass","description":"Lung transplant, single; with cardiopulmonary bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3670.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"S3835","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1392.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"47610","name":"Removal of gallbladder","description":"Cholecystectomy with exploration of common duct;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1050.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2217","name":"Foam filled caster tire each","description":"Manual wheelchair accessory, foam filled caster tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"36821","name":"Av fusion direct any site","description":"Arteriovenous anastomosis, open; direct, any site (eg, cimino type) (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78020","name":"Thyroid met uptake","description":"Thyroid carcinoma metastases uptake (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79300","name":"Nuclr rx interstit colloid","description":"Radiopharmaceutical therapy, by interstitial radioactive colloid administration","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"A6023","name":"Collagen dressing >48 sq in","description":"Collagen dressing, sterile, size more than 48 sq. in., each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":242.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1890","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8623","name":"Lith ion batt cid,non-earlvl","description":"Lithium ion battery for use with cochlear implant device speech processor, other than ear level, replacement, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"76360","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","date_of_service":"2026-05-10","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":"26110","name":"Biopsy finger joint lining","description":"Arthrotomy with biopsy; interphalangeal joint, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0421T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"68020","name":"Incise/drain eyelid lining","description":"Incision of conjunctiva, drainage of cyst","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86905","name":"Blood typing rbc antigens","description":"Blood typing, serologic; rbc antigens, other than abo or rh (d), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5280","name":"Hemipelvect canad sing axis","description":"Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35636","name":"Bpg splenorenal","description":"Bypass graft, with other than vein; splenorenal (splenic to renal arterial anastomosis)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2047.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":923.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82128","name":"Amino acids mult qual","description":"Amino acids; multiple, qualitative, each specimen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"21060","name":"Remove jaw joint cartilage","description":"Meniscectomy, partial or complete, temporomandibular joint (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"57310","name":"Repair urethrovaginal lesion","description":"Closure of urethrovaginal fistula;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":492.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"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":"2026-05-10","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":"86768","name":"Salmonella antibody","description":"Antibody; salmonella","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5073","name":"Urinary pouch on barr w/flng","description":"Ostomy pouch, urinary; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-10","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":"27704","name":"Removal of ankle implant","description":"Removal of ankle implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75885","name":"Vein x-ray liver w/hemodynam","description":"Percutaneous transhepatic portography with hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":314.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15839","name":"Exc excessive skn other area","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); other area","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4596","name":"Ces system monthly supp","description":"Cranial electrotherapy stimulation (ces) system supplies and accessories, per month","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"76819","name":"Fetal biophys profil w/o nst","description":"Fetal biophysical profile; without non-stress testing","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1376.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5858","name":"Stance phase only","description":"Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"59350","name":"Repair of uterus","description":"Hysterorrhaphy of ruptured uterus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":367.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1082.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51900","name":"Repair bladder/vagina lesion","description":"Closure of vesicovaginal fistula, abdominal approach","date_of_service":"2026-05-10","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":"64605","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58562","name":"Hysteroscopy remove fb","description":"Hysteroscopy, surgical; with removal of impacted foreign body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"42220","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate; secondary lengthening procedure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":655.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-10","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":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","date_of_service":"2026-05-10","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":"32603","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"27323","name":"Biopsy thigh soft tissues","description":"Biopsy, soft tissue of thigh or knee area; superficial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59840","name":"Induced abortion d&c","description":"Induced abortion, by dilation and curettage","date_of_service":"2026-05-10","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":"87110","name":"Chlamydia culture","description":"Culture, chlamydia, any source","date_of_service":"2026-05-10","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":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9600","name":"Porfimer sodium injection","description":"Injection, porfimer sodium, 75 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2285.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1854.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","date_of_service":"2026-05-10","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":"E0171","name":"Commode chair non-electric","description":"Commode chair with integrated seat lift mechanism, non-electric, any type","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6557","name":"G com stcking thgh30-40 cust","description":"Gradient compression stocking, thigh length, 30-40 mmhg, custom, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80188","name":"Assay of primidone","description":"Primidone","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27033","name":"Arthrt hip expl/rmv loose/fb","description":"Arthrotomy, hip, including exploration or removal of loose or foreign body","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75887","name":"Vein x-ray liver w/o hemodyn","description":"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26011","name":"Drainage of finger abscess","description":"Drainage of finger abscess; complicated (eg, felon)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"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":"01996","name":"Dly hosp mgmt edrl rx admin","description":"Daily hospital management of epidural or subarachnoid continuous drug administration","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61315","name":"Crnec/crnot ittl ntracereblr","description":"Craniectomy or craniotomy for evacuation of hematoma, infratentorial; intracerebellar","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2345.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78645","name":"Csf shunt evaluation","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); shunt evaluation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2101","name":"Single visn sphere 4.12-7.00","description":"Sphere, single vision, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"27420","name":"Revision of unstable kneecap","description":"Reconstruction of dislocating patella; (eg, hauser type procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1273.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5677","name":"Bk knee joints polycentric p","description":"Additions to lower extremity, below knee, knee joints, polycentric, pair","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59074","name":"Fetal fluid drainage w/us","description":"Fetal fluid drainage (eg, vesicocentesis, thoracocentesis, paracentesis), including ultrasound guidance","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26262","name":"Resect distal finger tumor","description":"Radical resection of tumor, distal phalanx of finger","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":531.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73592","name":"X-ray exam of leg infant","description":"Radiologic examination; lower extremity, infant, minimum of 2 views","date_of_service":"2026-05-10","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":"75870","name":"Vein x-ray skull","description":"Venography, superior sagittal sinus, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"25001","name":"Incise flexor carpi radialis","description":"Incision, flexor tendon sheath, wrist (eg, flexor carpi radialis)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2001","name":"Suct pum ext mgmt sys","description":"Suction pump, home model, portable or stationary, electric, any type, for use with external urine and/or fecal management system","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2357","name":"Omalizumab injection","description":"Injection, omalizumab, 5 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00842","name":"Anes iper px amniocentesis","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; amniocentesis","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9357","name":"Valrubicin injection","description":"Injection, valrubicin, intravesical, 200 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":369.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78191","name":"Platelet survival study","description":"Platelet survival study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83655","name":"Assay of lead","description":"Lead","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"88348","name":"Electron microscopy dx","description":"Electron microscopy, diagnostic","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86677","name":"Helicobacter pylori antibody","description":"Antibody; helicobacter pylori","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5505","name":"Init ak ischal plstr direct","description":"Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49040","name":"Drain open abdom abscess","description":"Drainage of subdiaphragmatic or subphrenic abscess, open","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28208","name":"Repair of foot tendon","description":"Repair, tendon, extensor, foot; primary or secondary, each tendon","date_of_service":"2026-05-10","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":"91020","name":"Gastric motility studies","description":"Gastric motility (manometric) studies","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"11463","name":"Exc skn hdrdnt ing complex","description":"Excision of skin and subcutaneous tissue for hidradenitis, inguinal; with complex repair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":321.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1844","name":"Ko w/adj jt rot cntrl molded","description":"Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6247","name":"Hydrogel drg > 48 sq in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"36460","name":"Intrauterine transfusion ftl","description":"Transfusion, intrauterine, fetal","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L6370","name":"Thoracic passive restor cap","description":"Interscapular thoracic, passive restoration (shoulder cap only)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["KL","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01742","name":"Anes opn/arthrs elbw osteot","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; osteotomy of humerus","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"94770","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"11772","name":"Exc pilonidal cyst comp","description":"Excision of pilonidal cyst or sinus; complicated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":582.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"26180","name":"Removal of finger tendon","description":"Excision of tendon, finger, flexor or extensor, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0373","name":"Nonpowered pressure mattress","description":"Nonpowered advanced pressure reducing mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"46750","name":"Repair of anal sphincter","description":"Sphincteroplasty, anal, for incontinence or prolapse; adult","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1240","name":"Lumbar derotation pad","description":"Addition to tlso, (low profile), lumbar derotation pad","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"92544","name":"Optokinetic nystagmus test","description":"Optokinetic nystagmus test, bidirectional, foveal or peripheral stimulation, with recording","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1145.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2063.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26700","name":"Treat knuckle dislocation","description":"Closed treatment of metacarpophalangeal dislocation, single, with manipulation; without anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1558.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":"53250","name":"Removal of urethra gland","description":"Excision of bulbourethral gland (cowpers gland)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30906","name":"Repeat control of nosebleed","description":"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; subsequent","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-05-10","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":"74247","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"53405","name":"Revise urethra stage 2","description":"Urethroplasty; second stage (formation of urethra), including urinary diversion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":957.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"26770","name":"Treat finger dislocation","description":"Closed treatment of interphalangeal joint dislocation, single, with manipulation; without anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1440","name":"Fecal microbiota jslm 1 ml","description":"Fecal microbiota, live - jslm, 1 ml","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2425","name":"Knee disc/dial lock/adj flex","description":"Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77327","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"28202","name":"Repair/graft of foot tendon","description":"Repair, tendon, flexor, foot; secondary with free graft, each tendon (includes obtaining graft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":345.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"64746","name":"Incise diaphragm nerve","description":"Transection or avulsion of; phrenic nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q2012","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"28119","name":"Removal of heel spur","description":"Ostectomy, calcaneus; for spur, with or without plantar fascial release","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86900","name":"Blood typing serologic abo","description":"Blood typing, serologic; abo","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5400","name":"Postop dress & 1 cast chg bk","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":374.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78272","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"48155","name":"Removal of pancreas","description":"Pancreatectomy, total","date_of_service":"2026-05-10","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":"00160","name":"Anes px nose&sinus nos","description":"Anesthesia for procedures on nose and accessory sinuses; not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3798.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"ATP08","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"46916","name":"Cryosurgery anal lesion(s)","description":"Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; cryosurgery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":997.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83894","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"74185","name":"Mra abd w or w/o cntrst","description":"Magnetic resonance angiography, abdomen, with or without contrast material(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"54522","name":"Orchiectomy partial","description":"Orchiectomy, partial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78811","name":"Pet image ltd area","description":"Positron emission tomography (pet) imaging; limited area (eg, chest, head/neck)","date_of_service":"2026-05-10","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":"0003A","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01215","name":"Anes opn revj tot hip arthrp","description":"Anesthesia for open procedures involving hip joint; revision of total hip arthroplasty","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":937.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":477.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4633","name":"Uvl replacement bulb","description":"Replacement bulb/lamp for ultraviolet light therapy system, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35616","name":"Bpg subclavian-axillary","description":"Bypass graft, with other than vein; subclavian-axillary","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":974.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5595","name":"Hip disartic sach thermopls","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1362.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1777.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0509T","name":"Pattern erg w/i&r","description":"Electroretinography (erg) with interpretation and report, pattern (perg)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87557","name":"M.tuberculo dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); mycobacteria tuberculosis, quantification","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"35211","name":"Rpr blvsl dir ntrathrc w/byp","description":"Repair blood vessel, direct; intrathoracic, with bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1609.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70030","name":"X-ray eye for foreign body","description":"Radiologic examination, eye, for detection of foreign body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"58293","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1622.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1800.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3090","name":"Arch supp att to shoe long/m","description":"Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4400","name":"Ostomy irrigation set","description":"Ostomy irrigation set","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-10","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":"01916","name":"Anes dx arteriography/vngrph","description":"Anesthesia for diagnostic arteriography/venography","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"24579","name":"Optx humrl cndylr fracture","description":"Open treatment of humeral condylar fracture, medial or lateral, includes internal fixation, when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1022.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27698","name":"Repair of ankle ligament","description":"Repair, secondary, disrupted ligament, ankle, collateral (eg, watson-jones procedure)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"87269","name":"Giardia ag if","description":"Infectious agent antigen detection by immunofluorescent technique; giardia","date_of_service":"2026-05-10","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":"62273","name":"Inject epidural patch","description":"Injection, epidural, of blood or clot patch","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"3079F","name":"Diast bp 80-89 mm hg","description":"Most recent diastolic blood pressure 80-89 mm hg (htn, ckd, cad) (dm)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A5072","name":"Urinary pouch w/o barrier","description":"Ostomy pouch, urinary; without barrier attached (1 piece), each","date_of_service":"2026-05-10","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":"73070","name":"X-ray exam of elbow","description":"Radiologic examination, elbow; 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24400","name":"Osteot humerus w/wo int fixj","description":"Osteotomy, humerus, with or without internal fixation","date_of_service":"2026-05-10","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":"E0445","name":"Oximeter non-invasive","description":"Oximeter device for measuring blood oxygen levels non-invasively","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62304","name":"Myelography lumbar injection","description":"Myelography via lumbar injection, including radiological supervision and interpretation; lumbosacral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"64795","name":"Biopsy of nerve","description":"Biopsy of nerve","date_of_service":"2026-05-10","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":"15300","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44156","name":"Removal of colon/ileostomy","description":"Colectomy, total, abdominal, with proctectomy; with continent ileostomy","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0748","name":"Elec osteogen stim spinal","description":"Osteogenesis stimulator, electrical, non-invasive, spinal applications","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2247.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":"V2201","name":"Lens sphere bifocal 4.12-7.0","description":"Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85441","name":"Heinz bodies direct","description":"Heinz bodies; direct","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"V2108","name":"Spherocylinder 4.25d/2.12-4d","description":"Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"50070","name":"Nl comp cgen kdn abnormality","description":"Nephrolithotomy; complicated by congenital kidney abnormality","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54620","name":"Suspension of testis","description":"Fixation of contralateral testis (separate procedure)","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"49555","name":"Rerepair fem hernia reduce","description":"Repair recurrent femoral hernia; reducible","date_of_service":"2026-05-10","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":"83036","name":"Hemoglobin glycosylated a1c","description":"Hemoglobin; glycosylated (a1c)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"87477","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2359","name":"Gr34 sealed leadacid battery","description":"Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82652","name":"Vit d 1 25-dihydroxy","description":"Vitamin d; 1, 25 dihydroxy, includes fraction(s), if performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"82120","name":"Amines vaginal fluid qual","description":"Amines, vaginal fluid, qualitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"70450","name":"Ct head/brain w/o dye","description":"Computed tomography, head or brain; without contrast material","date_of_service":"2026-05-10","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":"77778","name":"Apply interstit radiat compl","description":"Interstitial radiation source application, complex, includes supervision, handling, loading of radiation source, when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78135","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A7503","name":"Hmes filter holder or cap","description":"Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"31237","name":"Nsl/sins ndsc surg bx polypc","description":"Nasal/sinus endoscopy, surgical; with biopsy, polypectomy or debridement (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85247","name":"Clot factor viii multimetric","description":"Clotting; factor viii, von willebrand factor, multimetric analysis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q2009","name":"Fosphenytoin inj pe","description":"Injection, fosphenytoin, 50 mg phenytoin equivalent","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"17250","name":"Chem caut of granltj tissue","description":"Chemical cauterization of granulation tissue (ie, proud flesh)","date_of_service":"2026-05-10","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":"87470","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"70140","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; less than 3 views","date_of_service":"2026-05-10","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":"78610","name":"Brain flow imaging only","description":"Brain imaging, vascular flow only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0489","name":"Pwr pck base combo vad, rep","description":"Power pack base for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1284.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"75959","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":"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":"2026-05-10","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":"23190","name":"Ostectomy scapula partial","description":"Ostectomy of scapula, partial (eg, superior medial angle)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":665.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0112","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2750","name":"Anti-reflective coating","description":"Anti-reflective coating, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"Q0492","name":"Emr pwr cbl elec vad, rep","description":"Emergency power supply cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-10","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":"78103","name":"Bone marrow imaging mult","description":"Bone marrow imaging; multiple areas","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74249","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3360","name":"Shoe sole wedge outside sole","description":"Sole wedge, outside sole","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"65091","name":"Revise eye","description":"Evisceration of ocular contents; without implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":417.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73660","name":"X-ray exam of toe(s)","description":"Radiologic examination; toe(s), minimum of 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31511","name":"Remove foreign body larynx","description":"Laryngoscopy, indirect; with removal of foreign body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":390.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L2200","name":"Limited ankle motion ea jnt","description":"Addition to lower extremity, limited ankle motion, each joint","date_of_service":"2026-05-10","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":"22305","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75896","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":746.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72050","name":"X-ray exam neck spine 4/5vws","description":"Radiologic examination, spine, cervical; 4 or 5 views","date_of_service":"2026-05-10","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":"32484","name":"Segmentectomy","description":"Removal of lung, other than pneumonectomy; single segment (segmentectomy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1574.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27265","name":"Treat hip dislocation","description":"Closed treatment of post hip arthroplasty dislocation; without anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59130","name":"Treat ectopic pregnancy","description":"Surgical treatment of ectopic pregnancy; abdominal pregnancy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1026.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35515","name":"Art byp grft subclav-vertbrl","description":"Bypass graft, with vein; subclavian-vertebral","date_of_service":"2026-05-10","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":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87172","name":"Pinworm exam","description":"Pinworm exam (eg, cellophane tape prep)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00100","name":"Anes px salivary gland w/bx","description":"Anesthesia for procedures on salivary glands, including biopsy","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0442","name":"Stationary o2 contents, liq","description":"Stationary oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-10","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":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4426","name":"Ost pch drain 2 piece system","description":"Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6380","name":"Postop dsg cast chg wrst/elb","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5985","name":"Lwr ext dynamic prosth pylon","description":"All endoskeletal lower extremity prostheses, dynamic prosthetic pylon","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":168.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5530","name":"Prep bk ptb thermopls molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":857.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29904","name":"Subtalar arthro w/fb rmvl","description":"Arthroscopy, subtalar joint, surgical; with removal of loose body or foreign body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"62311","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4911","name":"Drain bag/bottle","description":"Drain bag/bottle, for dialysis, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":856.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83950","name":"Oncoprotein her-2/neu","description":"Oncoprotein; her-2/neu","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45355","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92265","name":"Ndl oculoelectromyography 1+","description":"Needle oculoelectromyography, 1 or more extraocular muscles, 1 or both eyes, with interpretation and report","date_of_service":"2026-05-10","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":"35646","name":"Bpg aortobifemoral","description":"Bypass graft, with other than vein; aortobifemoral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83001","name":"Assay of gonadotropin (fsh)","description":"Gonadotropin; follicle stimulating hormone (fsh)","date_of_service":"2026-05-10","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":"96530","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95951","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4730","name":"Fistula cannulation set, ea","description":"Fistula cannulation set for hemodialysis, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1284.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"68440","name":"Snip inc lacrimal punctum","description":"Snip incision of lacrimal punctum","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":231.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"33463","name":"Valvuloplasty tricuspid","description":"Valvuloplasty, tricuspid valve; without ring insertion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1897.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84119","name":"Test urine for porphyrins","description":"Porphyrins, urine; qualitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"87106","name":"Fungi identification yeast","description":"Culture, fungi, definitive identification, each organism; yeast","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88355","name":"M/phmtrc alys skeletal musc","description":"Morphometric analysis; skeletal muscle","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0731","name":"Conductive garment for tens/","description":"Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patients skin by layers of fabric)","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74010","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"55600","name":"Vesiculotomy","description":"Vesiculotomy;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1190","name":"Wheelchair amputee w/ leg re","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable elevating legrests","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":765.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5978","name":"Ft prosth multiaxial ankl/ft","description":"All lower extremity prostheses, foot, multiaxial ankle/foot","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26850","name":"Fusion of knuckle","description":"Arthrodesis, metacarpophalangeal joint, with or without internal fixation;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":585.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"49021","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"L2230","name":"Split flat caliper stirr & p","description":"Addition to lower extremity, split flat caliper stirrups and plate attachment","date_of_service":"2026-05-10","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":"37788","name":"Revascularization penis","description":"Penile revascularization, artery, with or without vein graft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1023.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00104","name":"Anes electroconvulsive ther","description":"Anesthesia for electroconvulsive therapy","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"64752","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1224","name":"Wheelchair spec size w/ leg","description":"Wheelchair with detachable arms, elevating legrests","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"43351","name":"Surgical opening esophagus","description":"Esophagostomy, fistulization of esophagus, external; thoracic approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1370.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0637","name":"Lso sc r ant/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","date_of_service":"2026-05-10","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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-10","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":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"60212","name":"Partial thyroid excision","description":"Partial thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1141.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-10","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":"27325","name":"Neurectomy hamstring","description":"Neurectomy, hamstring muscle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":"L5560","name":"Prep ak ischial plast molded","description":"Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28230","name":"Incision of foot tendon(s)","description":"Tenotomy, open, tendon flexor; foot, single or multiple tendon(s) (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"82489","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","date_of_service":"2026-05-10","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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"84061","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"86790","name":"Virus antibody nos","description":"Antibody; virus, not elsewhere specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"90675","name":"Rabies vaccine im","description":"Rabies vaccine, for intramuscular use","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":448.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26260","name":"Resect prox finger tumor","description":"Radical resection of tumor, proximal or middle phalanx of finger","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26516","name":"Fusion of knuckle joint","description":"Capsulodesis, metacarpophalangeal joint; single digit","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":594.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88740","name":"Transcutaneous carboxyhb","description":"Hemoglobin, quantitative, transcutaneous, per day; carboxyhemoglobin","date_of_service":"2026-05-10","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":"00880","name":"Anes maj lwr abd vessel nos","description":"Anesthesia for procedures on major lower abdominal vessels; not otherwise specified","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"23480","name":"Revision of collar bone","description":"Osteotomy, clavicle, with or without internal fixation;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57289","name":"Repair bladder & vagina","description":"Pereyra procedure, including anterior colporrhaphy","date_of_service":"2026-05-10","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":"31267","name":"Endoscopy maxillary sinus","description":"Nasal/sinus endoscopy, surgical, with maxillary antrostomy; with removal of tissue from maxillary sinus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78700","name":"Kidney imaging morphol","description":"Kidney imaging morphology;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72100","name":"X-ray exam l-s spine 2/3 vws","description":"Radiologic examination, spine, lumbosacral; 2 or 3 views","date_of_service":"2026-05-10","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":"83080","name":"Assay of b hexosaminidase ea","description":"B-hexosaminidase, each assay","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"51725","name":"Simple cystometrogram","description":"Simple cystometrogram (cmg) (eg, spinal manometer)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E1406","name":"O2/water vapor enrich w/o he","description":"Oxygen and water vapor enriching system without heated delivery","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"68550","name":"Remove tear gland lesion","description":"Excision of lacrimal gland tumor; involving osteotomy","date_of_service":"2026-05-10","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":"94725","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"86774","name":"Tetanus antibody","description":"Antibody; tetanus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"J0640","name":"Leucovorin calcium injection","description":"Injection, leucovorin calcium, per 50 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"33670","name":"Repair of heart chambers","description":"Repair of complete atrioventricular canal, with or without prosthetic valve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2347.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38745","name":"Remove armpit lymph nodes","description":"Axillary lymphadenectomy; complete","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"J9212","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77761","name":"Apply intrcav radiat simple","description":"Intracavitary radiation source application; simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71040","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22505","name":"Manipulation of spine","description":"Manipulation of spine requiring anesthesia, any region","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"93978","name":"Vascular study","description":"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33979","name":"Insert intracorporeal device","description":"Insertion of ventricular assist device, implantable intracorporeal, single ventricle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3020.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"86904","name":"Blood typing patient serum","description":"Blood typing, serologic; antigen screening for compatible unit using patient serum, per unit screened","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"00866","name":"Anes xtrprt lw abd adrnlctmy","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; adrenalectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"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":"80299","name":"Quantitative assay drug","description":"Quantitation of therapeutic drug, not elsewhere specified","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"26510","name":"Thumb tendon transfer","description":"Cross intrinsic transfer, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":815.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.38,"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":"00104","name":"Anes electroconvulsive ther","description":"Anesthesia for electroconvulsive therapy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0468","name":"Tlso rig fram pelvic pre cst","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal, and coronal","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1430.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0640","name":"Lso s/c shell/panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-10","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":"87592","name":"N.gonorrhoeae dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); neisseria gonorrhoeae, quantification","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3919","name":"Ho w/o joints cf","description":"Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"L0976","name":"Lso full corset","description":"Lso, full corset","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1574.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"25450","name":"Epiphysl arrst dstl rds/ulna","description":"Epiphyseal arrest by epiphysiodesis or stapling; distal radius or ulna","date_of_service":"2026-05-10","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":"31090","name":"Exploration of sinuses","description":"Sinusotomy, unilateral, 3 or more paranasal sinuses (frontal, maxillary, ethmoid, sphenoid)","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"49555","name":"Rerepair fem hernia reduce","description":"Repair recurrent femoral hernia; reducible","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":646.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1591.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1975.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82373","name":"Assay c-d transfer measure","description":"Carbohydrate deficient transferrin","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":849.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0671","name":"Pressure pneum appl full leg","description":"Segmental gradient pressure pneumatic appliance, full leg","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0491","name":"Tlso 2 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the ","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88173","name":"Cytopath eval fna report","description":"Cytopathology, evaluation of fine needle aspirate; interpretation and report","date_of_service":"2026-05-10","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":"92130","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"80299","name":"Quantitative assay drug","description":"Quantitation of therapeutic drug, not elsewhere specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26990","name":"Drainage of pelvis lesion","description":"Incision and drainage, pelvis or hip joint area; deep abscess or hematoma","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29836","name":"Elbow arthroscopy/surgery","description":"Arthroscopy, elbow, surgical; synovectomy, complete","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28260","name":"Release of midfoot joint","description":"Capsulotomy, midfoot; medial release only (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":422.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77014","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"27365","name":"Resect femur/knee tumor","description":"Radical resection of tumor, femur or knee","date_of_service":"2026-05-10","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":"59074","name":"Fetal fluid drainage w/us","description":"Fetal fluid drainage (eg, vesicocentesis, thoracocentesis, paracentesis), including ultrasound guidance","date_of_service":"2026-05-10","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":"26485","name":"Transplant palm tendon","description":"Transfer or transplant of tendon, palmar; without free tendon graft, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":676.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80202","name":"Assay of vancomycin","description":"Vancomycin","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A6025","name":"Silicone gel sheet, each","description":"Gel sheet for dermal or epidermal application, (e.g., silicone, hydrogel, other), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50543","name":"Laparo partial nephrectomy","description":"Laparoscopy, surgical; partial nephrectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1636.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0651","name":"Pneum compressor segmental","description":"Pneumatic compressor, segmental home model without calibrated gradient pressure","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95827","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"83935","name":"Assay of urine osmolality","description":"Osmolality; urine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27830","name":"Treat lower leg dislocation","description":"Closed treatment of proximal tibiofibular joint dislocation; without anesthesia","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1518.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2226","name":"Caster fork replacement only","description":"Manual wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-10","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":"45116","name":"Partial removal of rectum","description":"Proctectomy, partial, with anastomosis; transsacral approach only (kraske type)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1663.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93733","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30310","name":"Remove nasal foreign body","description":"Removal foreign body, intranasal; requiring general anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76001","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"99420","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"45378","name":"Diagnostic colonoscopy","description":"Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"78018","name":"Thyroid met imaging body","description":"Thyroid carcinoma metastases imaging; whole body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27650","name":"Repair achilles tendon","description":"Repair, primary, open or percutaneous, ruptured achilles tendon;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":855.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":909.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4561","name":"Pessary reusable rub anytype","description":"Pessary, reusable, rubber, any type","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77056","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"74355","name":"X-ray guide intestinal tube","description":"Percutaneous placement of enteroclysis tube, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"Q0482","name":"Microprcsr cu combo vad, rep","description":"Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4626","name":"Tracheostomy cleaning brush","description":"Tracheostomy cleaning brush, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1906","name":"Afo multilig ank sup pre ots","description":"Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64788","name":"Remove skin nerve lesion","description":"Excision of neurofibroma or neurolemmoma; cutaneous nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83527","name":"Assay of insulin","description":"Insulin; free","date_of_service":"2026-05-10","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":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2768","name":"Ortho sidebar disconnect","description":"Orthotic side bar disconnect device, per bar","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1050","name":"Whelchr fxd full length arms","description":"Fully-reclining wheelchair, fixed full length arms, swing away detachable elevating leg rests","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0132","name":"Acetylcysteine injection","description":"Injection, acetylcysteine, 100 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-05-10","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":"Q4032","name":"Cast sup lng leg ped fbrgls","description":"Cast supplies, long leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4434","name":"Ost pch urine w lock flng/ft","description":"Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31760","name":"Tracheoplasty intrathoracic","description":"Tracheoplasty; intrathoracic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1095.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2276.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"26370","name":"Repair finger/hand tendon","description":"Repair or advancement of profundus tendon, with intact superficialis tendon; primary, each tendon","date_of_service":"2026-05-10","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":"76514","name":"Echo exam of eye thickness","description":"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1170F","name":"Fxnl status assessed","description":"Functional status assessed (coa) (ra)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"86141","name":"C-reactive protein hs","description":"C-reactive protein; high sensitivity (hscrp)","date_of_service":"2026-05-10","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":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31648","name":"Bronchial valve remov init","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with removal of bronchial valve(s), initial lobe","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2780","name":"Non-corrosive finish","description":"Addition to lower extremity orthosis, non-corrosive finish, per bar","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27062","name":"Remove femur lesion/bursa","description":"Excision; trochanteric bursa or calcification","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":526.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55860","name":"Surgical exposure prostate","description":"Exposure of prostate, any approach, for insertion of radioactive substance;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":708.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"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":"2026-05-10","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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","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":"48400","name":"Injection intraop add-on","description":"Injection procedure for intraoperative pancreatography (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"66761","name":"Revision of iris","description":"Iridotomy/iridectomy by laser surgery (eg, for glaucoma) (per session)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["26"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2240.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"21800","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"69605","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1261.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0450","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35459","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8679","name":"Imp neurosti pls gn any type","description":"Implantable neurostimulator, pulse generator, any type","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01965","name":"Anes incompl/missed ab px","description":"Anesthesia for incomplete or missed abortion procedures","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"E1802","name":"Adjst forearm pro/sup device","description":"Dynamic adjustable forearm pronation/supination device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-10","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":"69005","name":"Drg xtrnl ear absc/hem comp","description":"Drainage external ear, abscess or hematoma; complicated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70210","name":"X-ray exam of sinuses","description":"Radiologic examination, sinuses, paranasal, less than 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92960","name":"Cardioversion electric ext","description":"Cardioversion, elective, electrical conversion of arrhythmia; external","date_of_service":"2026-05-10","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":"19020","name":"Mastotomy expl drg absc dp","description":"Mastotomy with exploration or drainage of abscess, deep","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75710","name":"Artery x-rays arm/leg","description":"Angiography, extremity, unilateral, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7193","name":"Factor ix non-recombinant","description":"Factor ix (antihemophilic factor, purified, non-recombinant) per i.u.","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01996","name":"Dly hosp mgmt edrl rx admin","description":"Daily hospital management of epidural or subarachnoid continuous drug administration","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.78,"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":"35533","name":"Art byp grft axill/fem/fem","description":"Bypass graft, with vein; axillary-femoral-femoral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":"E0983","name":"Add pwr joystick","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, joystick control","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"30420","name":"Reconstruction of nose","description":"Rhinoplasty, primary; including major septal repair","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"L1250","name":"Anterior asis pad","description":"Addition to tlso, (low profile), anterior asis pad","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75736","name":"Artery x-rays pelvis","description":"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"60520","name":"Removal of thymus gland","description":"Thymectomy, partial or total; transcervical approach (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1217.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0610","name":"Pacemaker monitr audible/vis","description":"Pacemaker monitor, self-contained, (checks battery depletion, includes audible and visible check systems)","date_of_service":"2026-05-10","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":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71111","name":"X-ray exam ribs/chest4/> vws","description":"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"75833","name":"Vein x-ray kidneys","description":"Venography, renal, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86698","name":"Histoplasma antibody","description":"Antibody; histoplasma","date_of_service":"2026-05-10","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":"75605","name":"Contrast exam thoracic aorta","description":"Aortography, thoracic, by serialography, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6602","name":"G com bandge hgh dn foamroll","description":"Gradient compression bandaging supply, high density foam roll for bandage, per linear yard, any width, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61570","name":"Remove foreign body brain","description":"Craniectomy or craniotomy; with excision of foreign body from brain","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1709.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6598","name":"G comp bandage med stretch","description":"Gradient compression bandage roll, elastic medium stretch, per linear yard, any width, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"00873","name":"Anes lithotrp esw wo wtr bth","description":"Anesthesia for lithotripsy, extracorporeal shock wave; without water bath","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-10","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":"32556","name":"Insert cath pleura w/o image","description":"Pleural drainage, percutaneous, with insertion of indwelling catheter; without imaging guidance","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59425","name":"Antepartum care only","description":"Antepartum care only; 4-6 visits","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-10","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":"V2512","name":"Cntct lens gas permbl bifocl","description":"Contact lens, gas permeable, bifocal, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L0627","name":"Lo sag ri an/pos pnl pre cst","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2624","name":"Polishing artifical eye","description":"Polishing/resurfacing of ocular prosthesis","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41108","name":"Biopsy of floor of mouth","description":"Biopsy of floor of mouth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74329","name":"X-ray for pancreas endoscopy","description":"Endoscopic catheterization of the pancreatic ductal system, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78320","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71022","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26110","name":"Biopsy finger joint lining","description":"Arthrotomy with biopsy; interphalangeal joint, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"J2794","name":"Inj risperdal consta, 0.5 mg","description":"Injection, risperidone (risperdal consta), 0.5 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3807","name":"Whfo w/o joints pre cst","description":"Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21336","name":"Open tx septal fx w/wo stabj","description":"Open treatment of nasal septal fracture, with or without stabilization","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":518.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87260","name":"Adenovirus ag if","description":"Infectious agent antigen detection by immunofluorescent technique; adenovirus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"V2211","name":"Lens sphcy bifo 7.25-12/.25-","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":278.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7025","name":"Replace chest compress vest","description":"High frequency chest wall oscillation system vest, replacement for use with patient owned equipment, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"94660","name":"Cpap initiation&mgmt","description":"Continuous positive airway pressure ventilation (cpap), initiation and management","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95903","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27626","name":"Remove ankle joint lining","description":"Arthrotomy, with synovectomy, ankle; including tenosynovectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43241","name":"Egd tube/cath insertion","description":"Esophagogastroduodenoscopy, flexible, transoral; with insertion of intraluminal tube or catheter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":171.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"01380","name":"Anes all clsd px knee joint","description":"Anesthesia for all closed procedures on knee joint","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J2322","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":985.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"88347","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["BA","KG","UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82672","name":"Assay of estrogen","description":"Estrogens; total","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77052","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"43754","name":"Dx gastr intub w/asp spec","description":"Gastric intubation and aspiration, diagnostic; single specimen (eg, acid analysis)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":517.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6970","name":"Interscapular-thor switch ct","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"49525","name":"Repair ing hernia sliding","description":"Repair inguinal hernia, sliding, any age","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":614.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"92226","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1221","name":"Wheelchair spec size w foot","description":"Wheelchair with fixed arm, footrests","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23466","name":"Repair shoulder capsule","description":"Capsulorrhaphy, glenohumeral joint, any type multidirectional instability","date_of_service":"2026-05-10","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":"00870","name":"Anes xtrprtl cystolithotomy","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; cystolithotomy","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0945","name":"Belt/harness extremity","description":"Extremity belt/harness","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35626","name":"Bpg aor-subcla/innom/carotid","description":"Bypass graft, with other than vein; aortosubclavian, aortoinnominate, or aortocarotid","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6713","name":"Ped term dev, hand, vol open","description":"Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82384","name":"Assay three catecholamines","description":"Catecholamines; fractionated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3962","name":"Sewho erbs palsey design abd","description":"Shoulder elbow wrist hand orthosis, abduction positioning, erbs palsey design, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01999","name":"Unlisted anes procedure","description":"Unlisted anesthesia procedure(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19316","name":"Mastopexy","description":"Mastopexy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":897.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E1815","name":"Adjust ankle ext & flex dev","description":"Dynamic adjustable ankle extension and flexion device, includes soft interface material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"99144","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"35456","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95827","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6722","name":"Hook/hand, hvy dty, vol clos","description":"Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-05-10","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":"33335","name":"Insert major vessel graft","description":"Insertion of graft, aorta or great vessels; with cardiopulmonary bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43196","name":"Esophagoscp guide wire dilat","description":"Esophagoscopy, rigid, transoral; with insertion of guide wire followed by dilation over guide wire","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"85547","name":"Rbc mechanical fragility","description":"Mechanical fragility, rbc","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"26561","name":"Repair of web finger","description":"Repair of syndactyly (web finger) each web space; with skin flaps and grafts","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":802.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66180","name":"Aqueous shunt eye w/graft","description":"Aqueous shunt to extraocular equatorial plate reservoir, external approach; with graft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25443","name":"Arthrp prostc dstl scph crpl","description":"Arthroplasty with prosthetic replacement; scaphoid carpal (navicular)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93736","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"73530","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01996","name":"Dly hosp mgmt edrl rx admin","description":"Daily hospital management of epidural or subarachnoid continuous drug administration","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"60000","name":"I&d thyroglssl dux cst infct","description":"Incision and drainage of thyroglossal duct cyst, infected","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75880","name":"Vein x-ray eye socket","description":"Venography, orbital, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61314","name":"Crnec/crnot ittl xdrl/sdrl","description":"Craniectomy or craniotomy for evacuation of hematoma, infratentorial; extradural or subdural","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2010.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":778.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"19330","name":"Rmvl ruptured breast implant","description":"Removal of ruptured breast implant, including implant contents (eg, saline, silicone gel)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":675.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73060","name":"X-ray exam of humerus","description":"Radiologic examination; humerus, minimum of 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75680","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95832","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"70373","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1492.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2213","name":"Lens sphcyl bifo 7.25-12/4.2","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9266","name":"Pegaspargase injection","description":"Injection, pegaspargase, per single dose vial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1459.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0839","name":"Pwc gp2 vhd sing pow opt s/b","description":"Power wheelchair, group 2 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2715","name":"Prism lens/es","description":"Prism, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1820","name":"Soft interface material","description":"Replacement soft interface material, dynamic adjustable extension/flexion device","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"48100","name":"Biopsy of pancreas open","description":"Biopsy of pancreas, open (eg, fine needle aspiration, needle core biopsy, wedge biopsy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L5450","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70170","name":"X-ray exam of tear duct","description":"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93304","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; follow-up or limited study","date_of_service":"2026-05-10","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":"27054","name":"Removal of hip joint lining","description":"Arthrotomy with synovectomy, hip joint","date_of_service":"2026-05-10","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":"97762","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0947","name":"Fracture frame attachmnts pe","description":"Fracture frame, attachments for complex pelvic traction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75658","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"78195","name":"Lymph system imaging","description":"Lymphatics and lymph nodes imaging","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6258","name":"Transparent film >16<=48 in","description":"Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"Q4033","name":"Cast sup lng leg cylinder pl","description":"Cast supplies, long leg cylinder cast, adult (11 years +), plaster","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"76872","name":"Us transrectal","description":"Ultrasound, transrectal;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1289.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86022","name":"Platelet antibodies","description":"Antibody identification; platelet antibodies","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"86300","name":"Immunoassay tumor ca 15-3","description":"Immunoassay for tumor antigen, quantitative; ca 15-3 (27.29)","date_of_service":"2026-05-10","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":"E0472","name":"Rad w backup invasive intrfc","description":"Respiratory assist device, bi-level pressure capability, with backup rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29828","name":"Sho arthrs srg bicp tenodsis","description":"Arthroscopy, shoulder, surgical; biceps tenodesis","date_of_service":"2026-05-10","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":"A6457","name":"Tubular dressing","description":"Tubular dressing with or without elastic, any width, per linear yard","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"89235","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"37187","name":"Venous mech thrombectomy","description":"Percutaneous transluminal mechanical thrombectomy, vein(s), including intraprocedural pharmacological thrombolytic injections and fluoroscopic guidance","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"93610","name":"Intra-atrial pacing","description":"Intra-atrial pacing","date_of_service":"2026-05-10","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":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"41145","name":"Tongue removal neck surgery","description":"Glossectomy; complete or total, with or without tracheostomy, with unilateral radical neck dissection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2845.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"J0900","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6031","name":"Rep interface handfng molded","description":"Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1080.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25920","name":"Amputate hand at wrist","description":"Disarticulation through wrist;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33961","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"23472","name":"Reconstruct shoulder joint","description":"Arthroplasty, glenohumeral joint; total shoulder (glenoid and proximal humeral replacement (eg, total shoulder))","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1780.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"V2301","name":"Lens sphere trifocal 4.12-7.","description":"Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":281.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"39402","name":"Mediastinoscpy w/lmph nod bx","description":"Mediastinoscopy; with lymph node biopsy(ies) (eg, lung cancer staging)","date_of_service":"2026-05-10","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":"L5580","name":"Prep ak ischial thermo mold","description":"Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4055","name":"Replace non-molded calf lace","description":"Replace non-molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-10","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":"92556","name":"Speech audiometry complete","description":"Speech audiometry threshold; with speech recognition","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"28288","name":"Partial removal of foot bone","description":"Ostectomy, partial, exostectomy or condylectomy, metatarsal head, each metatarsal head","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A9507","name":"In111 capromab","description":"Indium in-111 capromab pendetide, diagnostic, per study dose, up to 10 millicuries","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"55810","name":"Extensive prostate surgery","description":"Prostatectomy, perineal radical;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1441.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1030","name":"Lumbar bolster pad","description":"Addition to ctlso or scoliosis orthosis, lumbar bolster pad","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"S8189","name":"Trach supply noc","description":"Tracheostomy supply, not otherwise classified","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74480","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"A6531","name":"Compress stking bk30-40 surg","description":"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"73615","name":"Contrast x-ray of ankle","description":"Radiologic examination, ankle, arthrography, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"00211","name":"Anes icr px crnec/crnot hmtm","description":"Anesthesia for intracranial procedures; craniotomy or craniectomy for evacuation of hematoma","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"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":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":602.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0462","name":"Rocking bed w/ or w/o side r","description":"Rocking bed with or without side rails","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33853","name":"Rpr hypopl a-arch w/byp","description":"Repair of hypoplastic or interrupted aortic arch using autogenous or prosthetic material; with cardiopulmonary bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1591.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","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":"77762","name":"Apply intrcav radiat interm","description":"Intracavitary radiation source application; intermediate","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"G0113","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1901.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69502","name":"Mastoidectomy","description":"Mastoidectomy; complete","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1120.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4336","name":"Urethral insert","description":"Incontinence supply, urethral insert, any type, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1041.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"43400","name":"Ligate esophagus veins","description":"Ligation, direct, esophageal varices","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1277.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"22855","name":"Removal anterior instrmj","description":"Removal of anterior instrumentation","date_of_service":"2026-05-10","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":"47480","name":"Incision of gallbladder","description":"Cholecystotomy or cholecystostomy, open, with exploration, drainage, or removal of calculus (separate procedure)","date_of_service":"2026-05-10","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":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2041.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","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":"74470","name":"X-ray exam of kidney lesion","description":"Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47400","name":"Incision of liver duct","description":"Hepaticotomy or hepaticostomy with exploration, drainage, or removal of calculus","date_of_service":"2026-05-10","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":"01732","name":"Anes dx arthrs px elbow jt","description":"Anesthesia for diagnostic arthroscopic procedures of elbow joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"E0677","name":"Non pneum seq comp trunk","description":"Non-pneumatic sequential compression garment, trunk","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88319","name":"Enzyme histochemistry","description":"Special stain including interpretation and report; group iii, for enzyme constituents","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"31290","name":"Nasal/sinus endoscopy surg","description":"Nasal/sinus endoscopy, surgical, with repair of cerebrospinal fluid leak; ethmoid region","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0486","name":"Tlso rigidlined cust fab two","description":"Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlappin","date_of_service":"2026-05-10","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":"63172","name":"Drainage of spinal cyst","description":"Laminectomy with drainage of intramedullary cyst/syrinx; to subarachnoid space","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95933","name":"Blink reflex test","description":"Orbicularis oculi (blink) reflex, by electrodiagnostic testing","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5910","name":"Endo below knee alignable sy","description":"Addition, endoskeletal system, below knee, alignable system","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1026.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49082","name":"Abd paracentesis","description":"Abdominal paracentesis (diagnostic or therapeutic); without imaging guidance","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51736","name":"Urine flow measurement","description":"Simple uroflowmetry (ufr) (eg, stop-watch flow rate, mechanical uroflowmeter)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0010","name":"Admin hepatitis b vaccine","description":"Administration of hepatitis b vaccine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"75945","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"24134","name":"Sequestrectomy shft/dstl hum","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), shaft or distal humerus","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7045","name":"Pediatric electric hook","description":"Electric hook, switch or myoelectric controlled, pediatric","date_of_service":"2026-05-10","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":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86619","name":"Borrelia antibody","description":"Antibody; borrelia (relapsing fever)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"B4082","name":"Enteral ng tubing w/o stylet","description":"Nasogastric tubing without stylet","date_of_service":"2026-05-10","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":"58560","name":"Hysteroscopy resect septum","description":"Hysteroscopy, surgical; with division or resection of intrauterine septum (any method)","date_of_service":"2026-05-10","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":"L2037","name":"Kafo plas sing free knee mol","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"L5826","name":"Miniature knee joint","description":"Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","date_of_service":"2026-05-10","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":"69540","name":"Excision aural polyp","description":"Excision aural polyp","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01380","name":"Anes all clsd px knee joint","description":"Anesthesia for all closed procedures on knee joint","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3100","name":"Hallus-valgus nt dyn pre ots","description":"Hallus-valgus night dynamic splint, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95909","name":"Nrv cndj tst 5-6 studies","description":"Nerve conduction studies; 5-6 studies","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75833","name":"Vein x-ray kidneys","description":"Venography, renal, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6624","name":"Flex/ext/rotation wrist unit","description":"Upper extremity addition, flexion/extension and rotation wrist unit","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26250","name":"Extensive hand surgery","description":"Radical resection of tumor, metacarpal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":683.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","date_of_service":"2026-05-10","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":"L5682","name":"Bk thigh lacer glut/ischia m","description":"Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33426","name":"Repair of mitral valve","description":"Valvuloplasty, mitral valve, with cardiopulmonary bypass; with prosthetic ring","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":189.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1024.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1227","name":"Wheelchair spec sz spec ht a","description":"Special height arms for wheelchair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5695","name":"Ak sleeve susp neoprene/equa","description":"Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0946","name":"Fracture frame dual w cross","description":"Fracture, frame, dual with cross bars, attached to bed, (e.g., balken, 4 poster)","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"L3933","name":"Fo w/o joints cf","description":"Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L1960","name":"Afo pos solid ank plastic mo","description":"Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"95822","name":"Eeg coma or sleep only","description":"Electroencephalogram (eeg); recording in coma or sleep only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11101","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"89300","name":"Semen analysis w/huhner","description":"Semen analysis; presence and/or motility of sperm including huhner test (post coital)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45332","name":"Sigmoidoscopy w/fb removal","description":"Sigmoidoscopy, flexible; with removal of foreign body(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"82671","name":"Assay of estrogens","description":"Estrogens; fractionated","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"84105","name":"Assay of urine phosphorus","description":"Phosphorus inorganic (phosphate); urine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"49555","name":"Rerepair fem hernia reduce","description":"Repair recurrent femoral hernia; reducible","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41252","name":"Repair tongue laceration","description":"Repair of laceration of tongue, floor of mouth, over 2.6 cm or complex","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33961","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33891","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1319.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2859.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94621","name":"Cardiopulm exercise testing","description":"Cardiopulmonary exercise testing, including measurements of minute ventilation, co2 production, o2 uptake, and electrocardiographic recordings","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"36550","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8400","name":"Sheath below knee","description":"Prosthetic sheath, below knee, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"00350","name":"Anes px major vsl neck nos","description":"Anesthesia for procedures on major vessels of neck; not otherwise specified","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0640","name":"Lso s/c shell/panel custom","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5600","name":"Hip disart sach laminat mold","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"28113","name":"Part removal of metatarsal","description":"Ostectomy, complete excision; fifth metatarsal head","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32482","name":"Bilobectomy","description":"Removal of lung, other than pneumonectomy; 2 lobes (bilobectomy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23397","name":"Muscle transfers","description":"Muscle transfer, any type, shoulder or upper arm; multiple","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"66930","name":"Extraction of lens","description":"Removal of lens material; intracapsular, for dislocated lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77315","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L2080","name":"Hkafo unilat torsion cable","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1645.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88184","name":"Flowcytometry/ tc 1 marker","description":"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4426","name":"Ost pch drain 2 piece system","description":"Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94620","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"25107","name":"Remove wrist joint cartilage","description":"Arthrotomy, distal radioulnar joint including repair of triangular cartilage, complex","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":724.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95875","name":"Limb exercise test","description":"Ischemic limb exercise test with serial specimen(s) acquisition for muscle(s) metabolite(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7521","name":"Trach/laryn tube cuffed","description":"Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24565","name":"Cltx hum epcndylr fx w/mnpj","description":"Closed treatment of humeral epicondylar fracture, medial or lateral; with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"S8424","name":"Ready gradient sleeve","description":"Gradient pressure aid (sleeve), ready made","date_of_service":"2026-05-10","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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"78586","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J0835","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5973","name":"Ank-foot sys dors-plant flex","description":"Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00851","name":"Anes iper px tubal ligation","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; tubal ligation/transection","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1211.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"00472","name":"Anes prtl rib rescj thoracop","description":"Anesthesia for partial rib resection; thoracoplasty (any type)","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0680","name":"Non pneum comp control cal","description":"Non-pneumatic compression controller with sequential calibrated gradient pressure","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0494","name":"Emr hd pmp elec/combo, rep","description":"Emergency hand pump for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82553","name":"Creatine mb fraction","description":"Creatine kinase (ck), (cpk); mb fraction only","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"40510","name":"Partial excision of lip","description":"Excision of lip; transverse wedge excision with primary closure","date_of_service":"2026-05-10","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":"A4593","name":"Neuromod sti sys adj rehab","description":"Neuromodulation stimulator system, adjunct to rehabilitation therapy regime, controller","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64681","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent, with or without radiologic monitoring; superior hypogastric plexus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"95920","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4378","name":"Drainable rubber pch w/o fp","description":"Ostomy pouch, drainable, for use on faceplate, rubber, each","date_of_service":"2026-05-10","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":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"99333","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2502","name":"Contact lens pmma bifocal","description":"Contact lens, pmma, bifocal, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"55840","name":"Extensive prostate surgery","description":"Prostatectomy, retropubic radical, with or without nerve sparing;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":947.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"72070","name":"X-ray exam thorac spine 2vws","description":"Radiologic examination, spine; thoracic, 2 views","date_of_service":"2026-05-10","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":"L2360","name":"Extended steel shank","description":"Addition to lower extremity, extended steel shank","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":244.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00450","name":"Anes px clav&scapula nos","description":"Anesthesia for procedures on clavicle and scapula; not otherwise specified","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"15789","name":"Chemical peel facial dermal","description":"Chemical peel, facial; dermal","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0011A","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"76102","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"75960","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"76940","name":"Us guide tissue ablation","description":"Ultrasound guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2540","name":"Thigh/wght bear lacer molded","description":"Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"61558","name":"Excision of skull/sutures","description":"Extensive craniectomy for multiple cranial suture craniosynostosis (eg, cloverleaf skull); not requiring bone grafts","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58954","name":"Tah rad debulk/lymph remove","description":"Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical dissection for debulking; with pelvic lymphadenectomy and limited para-aortic lymphadenectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2435.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2030","name":"Kafo dbl solid stirrup w/o j","description":"Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar ak orthosis), without knee joint, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1118.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67715","name":"Canthotomy","description":"Canthotomy (separate procedure)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"93926","name":"Lower extremity study","description":"Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00148","name":"Anes px eye ophthalmoscopy","description":"Anesthesia for procedures on eye; ophthalmoscopy","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"K0837","name":"Pwc gp 2 hd sing pow opt s/b","description":"Power wheelchair, group 2 heavy duty, single power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9216","name":"Interferon gamma 1-b inj","description":"Injection, interferon, gamma 1-b, 3 million units","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":292.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":283.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5718","name":"Knee-shin exo frct swg & sta","description":"Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":845.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1324.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0745","name":"Neuromuscular stim for shock","description":"Neuromuscular stimulator, electronic shock unit","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90804","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1540.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1803","name":"Adjust elbow extension dev","description":"Dynamic adjustable elbow extension only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2624","name":"Hip adj flex ext abduct cont","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","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":"64630","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent; pudendal nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":193.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"96003","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"88371","name":"Protein western blot tissue","description":"Protein analysis of tissue by western blot, with interpretation and report;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0326","name":"Urinal female jug-type","description":"Urinal; female, jug-type, any material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L5653","name":"Knee disart expand wall sock","description":"Addition to lower extremity, knee disarticulation, expandable wall socket","date_of_service":"2026-05-10","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":"70336","name":"Magnetic image jaw joint","description":"Magnetic resonance (eg, proton) imaging, temporomandibular joint(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2157.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1995.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"51726","name":"Complex cystometrogram","description":"Complex cystometrogram (ie, calibrated electronic equipment);","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84157","name":"Assay of protein other","description":"Protein, total, except by refractometry; other source (eg, synovial fluid, cerebrospinal fluid)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"66155","name":"Glaucoma surgery","description":"Fistulization of sclera for glaucoma; thermocauterization with iridectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92250","name":"Fundus photography w/i&r","description":"Fundus photography with interpretation and report","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"J7500","name":"Azathioprine oral 50mg","description":"Azathioprine, oral, 50 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0105","name":"Cane adjust/fixed quad/3 pro","description":"Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips","date_of_service":"2026-05-10","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":"A4344","name":"Cath indw foley 2 way silicn","description":"Indwelling catheter, foley type, two-way, all silicone or polyurethane, each","date_of_service":"2026-05-10","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":"19140","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45379","name":"Colonoscopy w/fb removal","description":"Colonoscopy, flexible; with removal of foreign body(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82565","name":"Assay of creatinine","description":"Creatinine; blood","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39540","name":"Repair of diaphragm hernia","description":"Repair, diaphragmatic hernia (other than neonatal), traumatic; acute","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78007","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3965","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1219.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"90634","name":"Hepa vacc ped/adol 3 dose","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-10","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":"E1150","name":"Wheelchair standard w/ leg r","description":"Wheelchair, detachable arms, desk or full length swing away detachable elevating legrests","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-10","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":"64623","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","date_of_service":"2026-05-10","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":"61613","name":"Remove aneurysm sinus","description":"Obliteration of carotid aneurysm, arteriovenous malformation, or carotid-cavernous fistula by dissection within cavernous sinus","date_of_service":"2026-05-10","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":"64840","name":"Repair of leg nerve","description":"Suture of posterior tibial nerve","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77414","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"ATP19","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"93530","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"90661","name":"Cciiv3 vac abx fr 0.5 ml im","description":"Influenza virus vaccine, trivalent (cciiv3), derived from cell cultures, subunit, antibiotic free, 0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","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":49.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8511","name":"Indwelling trach insert","description":"Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"28003","name":"Treatment of foot infection","description":"Incision and drainage below fascia, with or without tendon sheath involvement, foot; multiple areas","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1475.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1539.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31375","name":"Partial removal of larynx","description":"Partial laryngectomy (hemilaryngectomy); laterovertical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1897.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":645.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"73140","name":"X-ray exam of finger(s)","description":"Radiologic examination, finger(s), minimum of 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78205","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26370","name":"Repair finger/hand tendon","description":"Repair or advancement of profundus tendon, with intact superficialis tendon; primary, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1058.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33321","name":"Repair major vessel","description":"Suture repair of aorta or great vessels; with shunt bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1473.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78740","name":"Ureteral reflux study","description":"Ureteral reflux study (radiopharmaceutical voiding cystogram)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-10","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":"86226","name":"Dna antibody single strand","description":"Deoxyribonucleic acid (dna) antibody; single stranded","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"L6035","name":"Prosthetic digit mechanical","description":"Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0490","name":"Control unit nm hw remote","description":"Power source and control electronics unit for oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, controlled by hardware remote","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","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":"ATP05","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"28103","name":"Remove/graft foot lesion","description":"Excision or curettage of bone cyst or benign tumor, talus or calcaneus; with allograft","date_of_service":"2026-05-10","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":"65770","name":"Keratoprosthesis","description":"Keratoprosthesis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1395.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":105.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2265","name":"Long tongue stirrup","description":"Addition to lower extremity, long tongue stirrup","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"70170","name":"X-ray exam of tear duct","description":"Dacryocystography, nasolacrimal duct, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1372","name":"Oxy suppl heater for nebuliz","description":"Immersion external heater for nebulizer","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1064.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"70371","name":"Speech evaluation complex","description":"Complex dynamic pharyngeal and speech evaluation by cine or video recording","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88375","name":"Optical endomicroscpy interp","description":"Optical endomicroscopic image(s), interpretation and report, real-time or referred, each endoscopic session","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47011","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"93561","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"97016","name":"Vasopneumatic device therapy","description":"Application of a modality to 1 or more areas; vasopneumatic devices","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11982","name":"Remove drug implant device","description":"Removal, non-biodegradable drug delivery implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44120","name":"Removal of small intestine","description":"Enterectomy, resection of small intestine; single resection and anastomosis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":666.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4357","name":"Bedside drainage bag","description":"Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5160","name":"Mold socket bent knee shin s","description":"Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0485","name":"Monitor cable elec vad, rep","description":"Monitor control cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-10","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":"85730","name":"Thromboplastin time partial","description":"Thromboplastin time, partial (ptt); plasma or whole blood","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"82435","name":"Assay of blood chloride","description":"Chloride; blood","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70250","name":"X-ray exam of skull","description":"Radiologic examination, skull; less than 4 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"86162","name":"Complement total (ch50)","description":"Complement; total hemolytic (ch50)","date_of_service":"2026-05-10","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":"ATP20","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3675","name":"So vest canvas/web pre ots","description":"Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":"32905","name":"Revise & repair chest wall","description":"Thoracoplasty, schede type or extrapleural (all stages);","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1066.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"A6240","name":"Hydrocolld drg filler paste","description":"Hydrocolloid dressing, wound filler, paste, sterile, per ounce","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"93533","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2886.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1119.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4390","name":"Drainable pch ex wear convex","description":"Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3927","name":"Fo pip dip no jt spr pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":"50728","name":"Revise ureter","description":"Revision of urinary-cutaneous anastomosis (any type urostomy); with repair of fascial defect and hernia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"50740","name":"Fusion of ureter & kidney","description":"Ureteropyelostomy, anastomosis of ureter and renal pelvis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42305","name":"Drainage of salivary gland","description":"Drainage of abscess; parotid, complicated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86805","name":"Lymphocytotoxicity assay","description":"Lymphocytotoxicity assay, visual crossmatch; with titration","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"82800","name":"Blood ph","description":"Gases, blood, ph only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"96402","name":"Chemo hormon antineopl sq/im","description":"Chemotherapy administration, subcutaneous or intramuscular; hormonal anti-neoplastic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23545","name":"Cltx acromclav dislc w/mnpj","description":"Closed treatment of acromioclavicular dislocation; with manipulation","date_of_service":"2026-05-10","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":"95867","name":"Ndl emg cranial nrv musc uni","description":"Needle electromyography; cranial nerve supplied muscle(s), unilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77315","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82544","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"36014","name":"Place catheter in artery","description":"Selective catheter placement, left or right pulmonary artery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29750","name":"Wedging of clubfoot cast","description":"Wedging of clubfoot cast","date_of_service":"2026-05-10","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":"33762","name":"Shunt desc aorta to pulm art","description":"Shunt; descending aorta to pulmonary artery (potts-smith type operation)","date_of_service":"2026-05-10","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":"82370","name":"X-ray assay calculus","description":"Calculus; x-ray diffraction","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"92544","name":"Optokinetic nystagmus test","description":"Optokinetic nystagmus test, bidirectional, foveal or peripheral stimulation, with recording","date_of_service":"2026-05-10","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":"00211","name":"Anes icr px crnec/crnot hmtm","description":"Anesthesia for intracranial procedures; craniotomy or craniectomy for evacuation of hematoma","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0617","name":"Automatic ext defibrillator","description":"External defibrillator with integrated electrocardiogram analysis","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63170","name":"Incise spinal cord tract(s)","description":"Laminectomy with myelotomy (eg, bischof or drez type), cervical, thoracic, or thoracolumbar","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1689.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":565.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3917","name":"Metacarp fx orthosis pre cst","description":"Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"29520","name":"Strapping of hip","description":"Strapping; hip","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5560","name":"Prep ak ischial plast molded","description":"Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3972","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"26844","name":"Fusion/graft of hand joint","description":"Arthrodesis, carpometacarpal joint, digit, other than thumb, each; with autograft (includes obtaining graft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":545.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L4130","name":"Replace pretibial shell","description":"Replace pretibial shell","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","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":"65103","name":"Remove eye/insert implant","description":"Enucleation of eye; with implant, muscles not attached to implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":796.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","date_of_service":"2026-05-10","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":"87271","name":"Cytomegalovirus dfa","description":"Infectious agent antigen detection by immunofluorescent technique; cytomegalovirus, direct fluorescent antibody (dfa)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L8642","name":"Hallux implant","description":"Hallux implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01260","name":"Anes all px veins upper leg","description":"Anesthesia for all procedures involving veins of upper leg, including exploration","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1308.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"69424","name":"Remove ventilating tube","description":"Ventilating tube removal requiring general anesthesia","date_of_service":"2026-05-10","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":"19306","name":"Mast rad urban type","description":"Mastectomy, radical, including pectoral muscles, axillary and internal mammary lymph nodes (urban type operation)","date_of_service":"2026-05-10","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":"G0419","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00190","name":"Anes px facial b1/skull nos","description":"Anesthesia for procedures on facial bones or skull; not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L2510","name":"Th/wght bear quad-lat brim m","description":"Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6237","name":"Hydrocolld drg <=16 in w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"35565","name":"Art byp grft iliofemoral","description":"Bypass graft, with vein; iliofemoral","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"31710","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88267","name":"Chromosome analys placenta","description":"Chromosome analysis, amniotic fluid or chorionic villus, count 15 cells, 1 karyotype, with banding","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92136","name":"Ophthalmic biometry","description":"Ophthalmic biometry by partial coherence interferometry with intraocular lens power calculation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28344","name":"Repair extra toe(s)","description":"Reconstruction, toe(s); polydactyly","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38214","name":"Volume deplete of harvest","description":"Transplant preparation of hematopoietic progenitor cells; plasma (volume) depletion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31290","name":"Nasal/sinus endoscopy surg","description":"Nasal/sinus endoscopy, surgical, with repair of cerebrospinal fluid leak; ethmoid region","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1370.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7523","name":"Tracheostomy shower protect","description":"Tracheostomy shower protector, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"82150","name":"Assay of amylase","description":"Amylase","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2288.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2126","name":"Kafo fem fx cast thermoplas","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6447","name":"Conform band s w >=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"97116","name":"Gait training therapy","description":"Therapeutic procedure, 1 or more areas, each 15 minutes; gait training (includes stair climbing)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74260","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2504","name":"Sgd prerec msg>20min <=40min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 20 minutes but less than or equal to 40 minutes recording time","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63180","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5683","name":"Initial custom socket insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1237","name":"Rgd ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, rigid, adjustable, without seating system","date_of_service":"2026-05-10","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":"L6965","name":"Shldr disartic myoelectronic","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"99217","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2387","name":"Add le poly knee custom kafo","description":"Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint","date_of_service":"2026-05-10","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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75731","name":"Artery x-rays adrenal gland","description":"Angiography, adrenal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86905","name":"Blood typing rbc antigens","description":"Blood typing, serologic; rbc antigens, other than abo or rh (d), each","date_of_service":"2026-05-10","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":"82550","name":"Assay of ck (cpk)","description":"Creatine kinase (ck), (cpk); total","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1060","name":"Wheelchair detachable arms","description":"Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62269","name":"Needle biopsy spinal cord","description":"Biopsy of spinal cord, percutaneous needle","date_of_service":"2026-05-10","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":"E1110","name":"Wheelchair semi-recl detach","description":"Semi-reclining wheelchair, detachable arms (desk or full length) elevating leg rest","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0250","name":"Hosp bed fixed ht w/ mattres","description":"Hospital bed, fixed height, with any type side rails, with mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0140","name":"Nav srv peer sup 60 min pr m","description":"Principal illness navigation - peer support by certified or trained auxiliary personnel under the direction of a physician or other practitioner, including a certified peer specialist; 60 minutes per calendar month, in the following activities:  person-centered interview, performed to better underst","date_of_service":"2026-05-10","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":"L0456","name":"Tlso flex trnk sj-ss pre cst","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"72131","name":"Ct lumbar spine w/o dye","description":"Computed tomography, lumbar spine; without contrast material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36160","name":"Establish access to aorta","description":"Introduction of needle or intracatheter, aortic, translumbar","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"77786","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"48540","name":"Fuse pancreas cyst and bowel","description":"Internal anastomosis of pancreatic cyst to gastrointestinal tract; roux-en-y","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1099.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73201","name":"Ct upper extremity w/dye","description":"Computed tomography, upper extremity; with contrast material(s)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8440","name":"Shrinker below knee","description":"Prosthetic shrinker, below knee, each","date_of_service":"2026-05-10","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":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00630","name":"Anes px lumbar region nos","description":"Anesthesia for procedures in lumbar region; not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["26"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"99303","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":691.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"35510","name":"Art byp grft carotid-brchial","description":"Bypass graft, with vein; carotid-brachial","date_of_service":"2026-05-10","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":"31624","name":"Dx bronchoscope/lavage","description":"Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial alveolar lavage","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36416","name":"Collj capillary blood spec","description":"Collection of capillary blood specimen (eg, finger, heel, ear stick)","date_of_service":"2026-05-10","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":"78635","name":"Csf ventriculography","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-10","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":"84512","name":"Assay of troponin qual","description":"Troponin, qualitative","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1609.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9045","name":"Carboplatin injection","description":"Injection, carboplatin, 50 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"27613","name":"Biopsy lower leg soft tissue","description":"Biopsy, soft tissue of leg or ankle area; superficial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1550.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19100","name":"Bx breast percut w/o image","description":"Biopsy of breast; percutaneous, needle core, not using imaging guidance (separate procedure)","date_of_service":"2026-05-10","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":"82374","name":"Assay blood carbon dioxide","description":"Carbon dioxide (bicarbonate)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"54830","name":"Remove epididymis lesion","description":"Excision of local lesion of epididymis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78469","name":"Heart infarct image (3d)","description":"Myocardial imaging, infarct avid, planar; tomographic spect with or without quantification","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"66630","name":"Removal of iris","description":"Iridectomy, with corneoscleral or corneal section; sector for glaucoma (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77332","name":"Radiation treatment aid(s)","description":"Treatment devices, design and construction; simple (simple block, simple bolus)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88237","name":"Tissue culture bone marrow","description":"Tissue culture for neoplastic disorders; bone marrow, blood cells","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5706","name":"Custom shape cvr knee disart","description":"Custom shaped protective cover, knee disarticulation","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0490","name":"Tlso rigid plastic pre one","description":"Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, res","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35492","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72170","name":"X-ray exam of pelvis","description":"Radiologic examination, pelvis; 1 or 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1401.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00218","name":"Anes icr px in sitting pos","description":"Anesthesia for intracranial procedures; procedures in sitting position","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":"26587","name":"Reconstruct extra finger","description":"Reconstruction of polydactylous digit, soft tissue and bone","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26568","name":"Lengthen metacarpal/finger","description":"Osteoplasty, lengthening, metacarpal or phalanx","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1205.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5420","name":"Postop dsg & 1 cast chg ak/d","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change ak or knee disarticulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":754.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20910","name":"Remove cartilage for graft","description":"Cartilage graft; costochondral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":505.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25505","name":"Cltx rdl shft fx w/mnpj","description":"Closed treatment of radial shaft fracture; with manipulation","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33203","name":"Insert epicard eltrd endo","description":"Insertion of epicardial electrode(s); endoscopic approach (eg, thoracoscopy, pericardioscopy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74430","name":"Contrast x-ray bladder","description":"Cystography, minimum of 3 views, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"76982","name":"Use 1st target lesion","description":"Ultrasound, elastography; first target lesion","date_of_service":"2026-05-10","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":"70100","name":"X-ray exam of jaw <4views","description":"Radiologic examination, mandible; partial, less than 4 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-10","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":"A6443","name":"Conform band n/s w>=3in<5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"76700","name":"Us exam abdom complete","description":"Ultrasound, abdominal, real time with image documentation; complete","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2123.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8612.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":894.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84620","name":"Xylose tolerance test","description":"Xylose absorption test, blood and/or urine","date_of_service":"2026-05-10","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":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0630","name":"Calcitonin salmon injection","description":"Injection, calcitonin salmon, up to 400 units","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"78202","name":"Liver imaging with vasc flow","description":"Liver imaging; with vascular flow","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1236","name":"Folding ped wc adjustable","description":"Wheelchair, pediatric size, folding, adjustable, with seating system","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"J1652","name":"Fondaparinux sodium","description":"Injection, fondaparinux sodium, 0.5 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":747.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55175","name":"Revision of scrotum","description":"Scrotoplasty; simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36460","name":"Intrauterine transfusion ftl","description":"Transfusion, intrauterine, fetal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":425.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1690.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0642","name":"Lo sag ri an/pos pnl pre ots","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51710","name":"Change of bladder tube","description":"Change of cystostomy tube; complicated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"J1566","name":"Immune globulin, powder","description":"Injection, immune globulin, intravenous, lyophilized (e.g., powder), not otherwise specified, 500 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1650","name":"Inj enoxaparin sodium","description":"Injection, enoxaparin sodium, 10 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3935","name":"Fo nontorsion joint cf","description":"Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1150","name":"Wheelchair standard w/ leg r","description":"Wheelchair, detachable arms, desk or full length swing away detachable elevating legrests","date_of_service":"2026-05-10","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":"67030","name":"Incise inner eye strands","description":"Discission of vitreous strands (without removal), pars plana approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":490.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"86148","name":"Anti-phospholipid antibody","description":"Anti-phosphatidylserine (phospholipid) antibody","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0247","name":"Trans bench w/wo comm open","description":"Transfer bench for tub or toilet with or without commode opening","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0450","name":"Tlso flex trunk/thor pre ots","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"95812","name":"Eeg 41-60 minutes","description":"Electroencephalogram (eeg) extended monitoring; 41-60 minutes","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"J2185","name":"Meropenem","description":"Injection, meropenem, 100 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"87482","name":"Candida dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); candida species, quantification","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":426.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99440","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51500","name":"Removal of bladder cyst","description":"Excision of urachal cyst or sinus, with or without umbilical hernia repair","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"E1820","name":"Soft interface material","description":"Replacement soft interface material, dynamic adjustable extension/flexion device","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83014","name":"H pylori drug admin","description":"Helicobacter pylori; drug administration","date_of_service":"2026-05-10","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":"L7008","name":"Pediatric electric hand","description":"Electric hand, switch or myoelectric, controlled, pediatric","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0478","name":"Power adapter, combo vad","description":"Power adapter for use with electric or electric/pneumatic ventricular assist device, vehicle type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L7266","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"80201","name":"Assay of topiramate","description":"Topiramate","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"20802","name":"Replantation arm complete","description":"Replantation, arm (includes surgical neck of humerus through elbow joint), complete amputation","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G0456","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":854.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37205","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":553.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L6584","name":"Elbow fair lead cable molded","description":"Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1971","name":"Afo w/ankle joint, prefab","description":"Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"36820","name":"Av fusion/forearm vein","description":"Arteriovenous anastomosis, open; by forearm vein transposition","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88173","name":"Cytopath eval fna report","description":"Cytopathology, evaluation of fine needle aspirate; interpretation and report","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51555","name":"Partial removal of bladder","description":"Cystectomy, partial; complicated (eg, postradiation, previous surgery, difficult location)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2220","name":"Dorsi & plantar flex ass/res","description":"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87109","name":"Mycoplasma","description":"Culture, mycoplasma, any source","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5618","name":"Test socket symes","description":"Addition to lower extremity, test socket, symes","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"J7520","name":"Sirolimus, oral","description":"Sirolimus, oral, 1 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1177.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6205","name":"Elbow molded w/ expand inter","description":"Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15951","name":"Exc trchntr pr ulc ostc","description":"Excision, trochanteric pressure ulcer, with primary suture; with ostectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0610","name":"Pacemaker monitr audible/vis","description":"Pacemaker monitor, self-contained, (checks battery depletion, includes audible and visible check systems)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70130","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; complete, minimum of 3 views per side","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70100","name":"X-ray exam of jaw <4views","description":"Radiologic examination, mandible; partial, less than 4 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"90811","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"50783","name":"Reimplant ureter in bladder","description":"Ureteroneocystostomy; with extensive ureteral tailoring","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82726","name":"Long chain fatty acids","description":"Very long chain fatty acids","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86021","name":"Wbc antibody identification","description":"Antibody identification; leukocyte antibodies","date_of_service":"2026-05-10","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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1335.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","date_of_service":"2026-05-10","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":"27606","name":"Incision of achilles tendon","description":"Tenotomy, percutaneous, achilles tendon (separate procedure); general anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0823","name":"Pwc gp 2 std cap chair","description":"Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1180.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77386","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6456","name":"Zinc paste band w >=3in<5in/yd","description":"Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45150","name":"Excision of rectal stricture","description":"Division of stricture of rectum","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24305","name":"Tendon lngth upr a/e ea tdn","description":"Tendon lengthening, upper arm or elbow, each tendon","date_of_service":"2026-05-10","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":"84585","name":"Assay of urine vma","description":"Vanillylmandelic acid (vma), urine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5230","name":"Fem focal defic constant fri","description":"Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33915","name":"Remove lung artery emboli","description":"Pulmonary artery embolectomy; without cardiopulmonary bypass","date_of_service":"2026-05-10","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":"27766","name":"Optx medial ankle fx","description":"Open treatment of medial malleolus fracture, includes internal fixation, when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":777.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1039","name":"Transport chair pt wt >300lb","description":"Transport chair, adult size, heavy duty, patient weight capacity greater than 300 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"74425","name":"Urography antegrade rs&i","description":"Urography, antegrade, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"71060","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"82607","name":"Vitamin b-12","description":"Cyanocobalamin (vitamin b-12);","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"93888","name":"Intracranial limited study","description":"Transcranial doppler study of the intracranial arteries; limited study","date_of_service":"2026-05-10","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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-10","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":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31576","name":"Laryngoscopy with biopsy","description":"Laryngoscopy, flexible; with biopsy(ies)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"93533","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75736","name":"Artery x-rays pelvis","description":"Angiography, pelvic, selective or supraselective, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-05-10","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":"90468","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"L2600","name":"Hip clevis/thrust bearing fr","description":"Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each","date_of_service":"2026-05-10","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":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"90821","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"L6711","name":"Ped term dev, hook, vol open","description":"Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2017.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.6,"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":"E0241","name":"Bath tub wall rail","description":"Bath tub wall rail, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75958","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1604.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2367","name":"Battery charger, dual mode","description":"Power wheelchair accessory, battery charger, dual mode, for use with either battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75831","name":"Vein x-ray kidney","description":"Venography, renal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-05-10","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":"15330","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95071","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"84425","name":"Assay of vitamin b-1","description":"Thiamine (vitamin b-1)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82010","name":"Ketone bodys quan","description":"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35180","name":"Rpr cgen av fistula head&nck","description":"Repair, congenital arteriovenous fistula; head and neck","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":946.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2415","name":"Knee joint cam lock each joi","description":"Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75966","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95010","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2305","name":"Lens sphcy trifocal 4.0/4.25","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00 cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2390","name":"Offset knee joint each","description":"Addition to lower extremity, offset knee joint, each joint","date_of_service":"2026-05-10","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":"66770","name":"Removal of inner eye lesion","description":"Destruction of cyst or lesion iris or ciliary body (nonexcisional procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A4559","name":"Coupling gel or paste","description":"Coupling gel or paste, for use with ultrasound device, per oz","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1254.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"30560","name":"Lysis intranasal synechia","description":"Lysis intranasal synechia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3300","name":"Sho lift taper to metatarsal","description":"Lift, elevation, heel, tapered to metatarsals, per inch","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":542.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","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":"00920","name":"Anes px male genitalia nos","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); not otherwise specified","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6597","name":"G comp bandage long stretch","description":"Gradient compression bandage roll, elastic long stretch, linear yard, any width, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1954.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9355","name":"Inj trastuzumab excl biosimi","description":"Injection, trastuzumab, excludes biosimilar, 10 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"J1390","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00124","name":"Anes px ear otoscopy","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; otoscopy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"A7509","name":"Heat & moisture exchange sys","description":"Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27626","name":"Remove ankle joint lining","description":"Arthrotomy, with synovectomy, ankle; including tenosynovectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":788.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84166","name":"Protein e-phoresis/urine/csf","description":"Protein; electrophoretic fractionation and quantitation, other fluids with concentration (eg, urine, csf)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"67840","name":"Remove eyelid lesion","description":"Excision of lesion of eyelid (except chalazion) without closure or with simple direct closure","date_of_service":"2026-05-10","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":"L6688","name":"Frame typ sock above elb/dis","description":"Upper extremity addition, frame type socket, above elbow or elbow disarticulation","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1464.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29847","name":"Wrist arthroscopy/surgery","description":"Arthroscopy, wrist, surgical; internal fixation for fracture or instability","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"87496","name":"Cytomeg dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); cytomegalovirus, amplified probe technique","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3901","name":"Hinge ext/flex wrist finger","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"47802","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1279.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22526","name":"Idet single level","description":"Percutaneous intradiscal electrothermal annuloplasty, unilateral or bilateral including fluoroscopic guidance; single level","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57022","name":"I&d vaginal hematoma ob/pp","description":"Incision and drainage of vaginal hematoma; obstetrical/postpartum","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-10","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":"23222","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86735","name":"Mumps antibody","description":"Antibody; mumps","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49427","name":"Injection abdominal shunt","description":"Injection procedure (eg, contrast media) for evaluation of previously placed peritoneal-venous shunt","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5616","name":"Ak univ multiplex sys frict","description":"Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3806","name":"Whfo w/joint(s) custom fab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1312.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2744","name":"Tint photochromatic lens/es","description":"Tint, photochromatic, per lens","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"69421","name":"Incision of eardrum","description":"Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["BA","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","date_of_service":"2026-05-10","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":"L1070","name":"Trapezius sling","description":"Addition to ctlso or scoliosis orthosis, trapezius sling","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27816","name":"Treatment of ankle fracture","description":"Closed treatment of trimalleolar ankle fracture; without manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":542.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77321","name":"Special teletx port plan","description":"Special teletherapy port plan, particles, hemibody, total body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"ATP12","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"G0392","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01782","name":"Anes vn upr arm&elbw phlbrpy","description":"Anesthesia for procedures on veins of upper arm and elbow; phleborrhaphy","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77056","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"94200","name":"Lung function test (mbc/mvv)","description":"Maximum breathing capacity, maximal voluntary ventilation","date_of_service":"2026-05-10","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":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00103","name":"Anes rcnstv px eyelid","description":"Anesthesia for reconstructive procedures of eyelid (eg, blepharoplasty, ptosis surgery)","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1020.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50760","name":"Ureteroureterostomy","description":"Ureteroureterostomy","date_of_service":"2026-05-10","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":"25111","name":"Remove wrist tendon lesion","description":"Excision of ganglion, wrist (dorsal or volar); primary","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93980","name":"Penile vascular study","description":"Duplex scan of arterial inflow and venous outflow of penile vessels; complete study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"62194","name":"Replace/irrigate catheter","description":"Replacement or irrigation, subarachnoid/subdural catheter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"19272","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"J0795","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G9980","name":"Remote e/m new pt 30 mins","description":"Remote in-home visit for the evaluation and management of a new patient for use only in a medicare-approved bundled payments for care improvement advanced (bpci advanced) model episode of care, which requires these 3 key components: a detailed history; a detailed examination; medical decision making","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54231","name":"Dynamic cavernosometry","description":"Dynamic cavernosometry, including intracavernosal injection of vasoactive drugs (eg, papaverine, phentolamine)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64530","name":"N block inj celiac pelus","description":"Injection, anesthetic agent; celiac plexus, with or without radiologic monitoring","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","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":"L5782","name":"Hd low limb pros vacuum pump","description":"Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0471","name":"Rad w/backup non inv intrfc","description":"Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":429.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1831","name":"Static str toe dev ext/flex","description":"Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2104","name":"Spherocylindr 4.00d/2.12-4d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82441","name":"Test for chlorohydrocarbons","description":"Chlorinated hydrocarbons, screen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33285","name":"Insj subq car rhythm mntr","description":"Insertion, subcutaneous cardiac rhythm monitor, including programming","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86753","name":"Protozoa antibody nos","description":"Antibody; protozoa, not elsewhere specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86671","name":"Fungus nes antibody","description":"Antibody; fungus, not elsewhere specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84445","name":"Assay of tsi globulin","description":"Thyroid stimulating immune globulins (tsi)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6446","name":"Conform band s w>=3in <5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"55041","name":"Removal of hydroceles","description":"Excision of hydrocele; bilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0958","name":"Whlchr att- conv 1 arm drive","description":"Manual wheelchair accessory, one-arm drive attachment, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00842","name":"Anes iper px amniocentesis","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; amniocentesis","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5780","name":"Knee-shin pneum/hydra pneum","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"77777","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"E1295","name":"Wheelchair heavy duty fixed","description":"Heavy duty wheelchair, fixed full length arms, elevating legrest","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"27060","name":"Removal of ischial bursa","description":"Excision; ischial bursa","date_of_service":"2026-05-10","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":"89190","name":"Nasal smear for eosinophils","description":"Nasal smear for eosinophils","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4265","name":"Paraffin","description":"Paraffin, per pound","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75710","name":"Artery x-rays arm/leg","description":"Angiography, extremity, unilateral, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1327.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2525","name":"Th/wght bear nar m-l brim mo","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00162","name":"Anes px nose&sinus rad surg","description":"Anesthesia for procedures on nose and accessory sinuses; radical surgery","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1193.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2484.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2590","name":"Oxytocin injection","description":"Injection, oxytocin, up to 10 units","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"76080","name":"X-ray exam of fistula","description":"Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6684","name":"Test socket shldr disart/tho","description":"Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"67121","name":"Remove eye implant material","description":"Removal of implanted material, posterior segment; intraocular","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4013","name":"Cast sup gauntlet plaster","description":"Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"B4083","name":"Enteral stomach tube levine","description":"Stomach tube - levine type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"61519","name":"Remove brain lining lesion","description":"Craniectomy for excision of brain tumor, infratentorial or posterior fossa; meningioma","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3429.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1821","name":"Replacement interface spsd","description":"Replacement soft interface material/cuffs for bi-directional static progressive stretch device","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","date_of_service":"2026-05-10","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":"87512","name":"Gardner vag dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); gardnerella vaginalis, quantification","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1033.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7005","name":"Nondisposable nebulizer set","description":"Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2425","name":"Palifermin injection","description":"Injection, palifermin, 50 micrograms","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0105","name":"Colorectal scrn; hi risk ind","description":"Colorectal cancer screening; colonoscopy on individual at high risk","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95958","name":"Eeg monitoring/function test","description":"Wada activation test for hemispheric function, including electroencephalographic (eeg) monitoring","date_of_service":"2026-05-10","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":"31287","name":"Nasal/sinus endoscopy surg","description":"Nasal/sinus endoscopy, surgical, with sphenoidotomy;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J7343","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"61682","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; supratentorial, complex","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50021","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73206","name":"Ct angio upr extrm w/o&w/dye","description":"Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if performed, and image postprocessing","date_of_service":"2026-05-10","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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"11762","name":"Reconstruction of nail bed","description":"Reconstruction of nail bed with graft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93618","name":"Indctj arrhythmia elec pacg","description":"Induction of arrhythmia by electrical pacing","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26580","name":"Repair cleft hand","description":"Repair cleft hand","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1537.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72190","name":"X-ray exam of pelvis","description":"Radiologic examination, pelvis; complete, minimum of 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37718","name":"Lig div&strpg short saph vn","description":"Ligation, division, and stripping, short saphenous vein","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"13160","name":"Sec clsr surg wnd/dehsn xtn","description":"Secondary closure of surgical wound or dehiscence, extensive or complicated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95075","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2601","name":"Gen w/c cushion wdth < 22 in","description":"General use wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":"33223","name":"Relocate pocket for defib","description":"Relocation of skin pocket for implantable defibrillator","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77422","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"01829","name":"Anes dx arthroscopic px wrst","description":"Anesthesia for diagnostic arthroscopic procedures on the wrist","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"26497","name":"Finger tendon transfer","description":"Transfer of tendon to restore intrinsic function; ring and small finger","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1129.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"0503T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"26605","name":"Treat metacarpal fracture","description":"Closed treatment of metacarpal fracture, single; with manipulation, each bone","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26250","name":"Extensive hand surgery","description":"Radical resection of tumor, metacarpal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0112","name":"Cranial cervical orthosis","description":"Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":692.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["BA","KG","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99295","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1077.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0423","name":"Intens cardiac rehab no exer","description":"Intensive cardiac rehabilitation; with or without continuous ecg monitoring; without exercise, per session","date_of_service":"2026-05-10","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":"78007","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74291","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"35302","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; superficial femoral artery","date_of_service":"2026-05-10","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":"62267","name":"Interdiscal perq aspir dx","description":"Percutaneous aspiration within the nucleus pulposus, intervertebral disc, or paravertebral tissue for diagnostic purposes","date_of_service":"2026-05-10","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":"65730","name":"Corneal transplant","description":"Keratoplasty (corneal transplant); penetrating (except in aphakia or pseudophakia)","date_of_service":"2026-05-10","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":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"Q0491","name":"Emr pwr source combo vad rep","description":"Emergency power source for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2916","name":"Na ferric gluconate complex","description":"Injection, sodium ferric gluconate complex in sucrose injection, 12.5 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2120","name":"Pulse gen sys tx endolymp fl","description":"Pulse generator system for tympanic treatment of inner ear endolymphatic fluid","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-10","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":"88380","name":"Microdissection laser","description":"Microdissection (ie, sample preparation of microscopically identified target); laser capture","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2580","name":"Pelvic control pelvic sling","description":"Addition to lower extremity, pelvic control, pelvic sling","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5645","name":"Bk flex inner socket ext fra","description":"Addition to lower extremity, below knee, flexible inner socket, external frame","date_of_service":"2026-05-10","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":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"84207","name":"Assay of vitamin b-6","description":"Pyridoxal phosphate (vitamin b-6)","date_of_service":"2026-05-10","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":"88329","name":"Path consltj drg surg","description":"Pathology consultation during surgery;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00524","name":"Anes clsd ch px pneumocents","description":"Anesthesia for closed chest procedures; pneumocentesis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"A4617","name":"Mouth piece","description":"Mouth piece","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"95957","name":"Eeg digital analysis","description":"Digital analysis of electroencephalogram (eeg) (eg, for epileptic spike analysis)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":671.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3710","name":"Eo elas w/metal jnts pre ots","description":"Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":"77786","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":124.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27780","name":"Treatment of fibula fracture","description":"Closed treatment of proximal fibula or shaft fracture; without manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":233.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83902","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"00790","name":"Anes iper upr abd nos","description":"Anesthesia for intraperitoneal procedures in upper abdomen including laparoscopy; not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53020","name":"Incision of urethra","description":"Meatotomy, cutting of meatus (separate procedure); except infant","date_of_service":"2026-05-10","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":"00542","name":"Anes thrcm px decortication","description":"Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); decortication","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.16,"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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"86039","name":"Antinuclear antibodies (ana)","description":"Antinuclear antibodies (ana); titer","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"87620","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6558","name":"G com stcking thgh 40+ cust","description":"Gradient compression stocking, thigh length, 40 mmhg or greater, custom, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6940","name":"Elbow disarticulation switch","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"42226","name":"Lengthening of palate","description":"Lengthening of palate, and pharyngeal flap","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27889","name":"Ankle disarticulation","description":"Ankle disarticulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1238","name":"Fld ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, folding, adjustable, without seating system","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":764.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29838","name":"Elbow arthroscopy/surgery","description":"Arthroscopy, elbow, surgical; debridement, extensive","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":321.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":705.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84449","name":"Assay of transcortin","description":"Transcortin (cortisol binding globulin)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G6022","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5073","name":"Urinary pouch on barr w/flng","description":"Ostomy pouch, urinary; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"21044","name":"Removal of jaw bone lesion","description":"Excision of malignant tumor of mandible;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69100","name":"Biopsy of external ear","description":"Biopsy external ear","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"01170","name":"Anes opn px symph pub/si jt","description":"Anesthesia for open procedures involving symphysis pubis or sacroiliac joint","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1740.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"50770","name":"Splicing of ureters","description":"Transureteroureterostomy, anastomosis of ureter to contralateral ureter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76975","name":"Gi endoscopic ultrasound","description":"Gastrointestinal endoscopic ultrasound, supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35471","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":641.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"25170","name":"Resect radius/ulnar tumor","description":"Radical resection of tumor, radius or ulna","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":553.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1462.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E1831","name":"Static str toe dev ext/flex","description":"Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","date_of_service":"2026-05-10","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":"86684","name":"Hemophilus influenza antibdy","description":"Antibody; haemophilus influenza","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1045.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5824","name":"Endo knee-shin fluid swing p","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing phase control","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92120","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78650","name":"Csf leakage imaging","description":"Cerebrospinal fluid leakage detection and localization","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"75995","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7044","name":"Pap oral interface","description":"Oral interface used with positive airway pressure device, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92960","name":"Cardioversion electric ext","description":"Cardioversion, elective, electrical conversion of arrhythmia; external","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4314","name":"Cath w/drainage 2-way latex","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5620","name":"Test socket below knee","description":"Addition to lower extremity, test socket, below knee","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1317.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85460","name":"Hemoglobin fetal","description":"Hemoglobin or rbcs, fetal, for fetomaternal hemorrhage; differential lysis (kleihauer-betke)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1173.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2111","name":"Spherocylindr 7.25d/.25-2.25","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2665.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":526.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4360","name":"Pneumat walking boot pre cst","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78350","name":"Bone mineral single photon","description":"Bone density (bone mineral content) study, 1 or more sites; single photon absorptiometry","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5827","name":"Endo knee shin single axis","description":"Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"90839","name":"Psytx crisis initial 60 min","description":"Psychotherapy for crisis; first 60 minutes","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43247","name":"Egd remove foreign body","description":"Esophagogastroduodenoscopy, flexible, transoral; with removal of foreign body(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"94360","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"58957","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"25350","name":"Revision of radius","description":"Osteotomy, radius; distal third","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"68815","name":"Probe nasolacrimal duct","description":"Probing of nasolacrimal duct, with or without irrigation; with insertion of tube or stent","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2156.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"43244","name":"Egd varices ligation","description":"Esophagogastroduodenoscopy, flexible, transoral; with band ligation of esophageal/gastric varices","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0457","name":"Chest shell","description":"Chest shell (cuirass)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94250","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22855","name":"Removal anterior instrmj","description":"Removal of anterior instrumentation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50727","name":"Revise ureter","description":"Revision of urinary-cutaneous anastomosis (any type urostomy);","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":414.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3222","name":"Mens shoes hightop depth inl","description":"Orthopedic footwear, mens shoe, hightop, depth inlay, each","date_of_service":"2026-05-10","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":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"59350","name":"Repair of uterus","description":"Hysterorrhaphy of ruptured uterus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"P9016","name":"Rbc leukocytes reduced","description":"Red blood cells, leukocytes reduced, each unit","date_of_service":"2026-05-10","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":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"20822","name":"Replantation digit complete","description":"Replantation, digit, excluding thumb (includes distal tip to sublimis tendon insertion), complete amputation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1503.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5131","name":"Appliance cleaner","description":"Appliance cleaner, incontinence and ostomy appliances, per 16 oz.","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46260","name":"Remove in/ex hem groups 2+","description":"Hemorrhoidectomy, internal and external, 2 or more columns/groups;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"91040","name":"Esoph balloon distension tst","description":"Esophageal balloon distension study, diagnostic, with provocation when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"50393","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"80188","name":"Assay of primidone","description":"Primidone","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35475","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"51605","name":"Preparation for bladder xray","description":"Injection procedure and placement of chain for contrast and/or chain urethrocystography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26508","name":"Release thumb contracture","description":"Release of thenar muscle(s) (eg, thumb contracture)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"78264","name":"Gastric emptying img study","description":"Gastric emptying imaging study (eg, solid, liquid, or both);","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP07","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3766","name":"Ewhfo w/joint(s) cf","description":"Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"92992","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0416","name":"Prostate biopsy, any mthd","description":"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0113","name":"Crutch underarm each wood","description":"Crutch underarm, wood, adjustable or fixed, each, with pad, tip and handgrip","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29105","name":"Application long arm splint","description":"Application of long arm splint (shoulder to hand)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"L2610","name":"Hip clevis/thrust bearing lo","description":"Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76604","name":"Us exam chest","description":"Ultrasound, chest (includes mediastinum), real time with image documentation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92260","name":"Ophthalmodynamometry","description":"Ophthalmodynamometry","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":784.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88740","name":"Transcutaneous carboxyhb","description":"Hemoglobin, quantitative, transcutaneous, per day; carboxyhemoglobin","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"69505","name":"Remove mastoid structures","description":"Mastoidectomy; modified radical","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3550","name":"O shoe add standard toe tap","description":"Orthopedic shoe addition, toe tap standard","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"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":"2026-05-10","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":"53515","name":"Repair of urethra injury","description":"Urethrorrhaphy, suture of urethral wound or injury; prostatomembranous","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"40831","name":"Repair mouth laceration","description":"Closure of laceration, vestibule of mouth; over 2.5 cm or complex","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1710","name":"Legg perthes orth newington","description":"Legg perthes orthosis, (newington type), custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95866","name":"Needle emg hemidiaphragm","description":"Needle electromyography; hemidiaphragm","date_of_service":"2026-05-10","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":"91120","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"92585","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0165","name":"Commode chair with detacharm","description":"Commode chair, mobile or stationary, with detachable arms","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"0493T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01920","name":"Anes cardiac catheterization","description":"Anesthesia for cardiac catheterization including coronary angiography and ventriculography (not to include swan-ganz catheter)","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"67041","name":"Vit for macular pucker","description":"Vitrectomy, mechanical, pars plana approach; with removal of preretinal cellular membrane (eg, macular pucker)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"10005","name":"Fna bx w/us gdn 1st les","description":"Fine needle aspiration biopsy, including ultrasound guidance; first lesion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J2321","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":949.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"27041","name":"Biopsy of soft tissues","description":"Biopsy, soft tissue of pelvis and hip area; deep, subfascial or intramuscular","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77293","name":"Respirator motion mgmt simul","description":"Respiratory motion management simulation (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"31075","name":"Exploration of frontal sinus","description":"Sinusotomy frontal; transorbital, unilateral (for mucocele or osteoma, lynch type)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":888.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84106","name":"Test for porphobilinogen","description":"Porphobilinogen, urine; qualitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76512","name":"Oph us dx b-scan","description":"Ophthalmic ultrasound, diagnostic; b-scan (with or without superimposed non-quantitative a-scan)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","date_of_service":"2026-05-10","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":"V2111","name":"Spherocylindr 7.25d/.25-2.25","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0635","name":"Lso sagit rigid panel prefab","description":"Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pr","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":474.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":322.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"L3766","name":"Ewhfo w/joint(s) cf","description":"Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01996","name":"Dly hosp mgmt edrl rx admin","description":"Daily hospital management of epidural or subarachnoid continuous drug administration","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.78,"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":"78305","name":"Bone imaging multiple areas","description":"Bone and/or joint imaging; multiple areas","date_of_service":"2026-05-10","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":"42510","name":"Parotid duct diversion","description":"Parotid duct diversion, bilateral (wilke type procedure); with ligation of both submandibular (whartons) ducts","date_of_service":"2026-05-10","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":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","date_of_service":"2026-05-10","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":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","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":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33211","name":"Insert card electrodes dual","description":"Insertion or replacement of temporary transvenous dual chamber pacing electrodes (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":702.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0457","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":"L6616","name":"Disconnect insert locking wr","description":"Upper extremity addition, additional disconnect insert for locking wrist unit, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"61070","name":"Brain canal shunt procedure","description":"Puncture of shunt tubing or reservoir for aspiration or injection procedure","date_of_service":"2026-05-10","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":"70551","name":"Mri brain stem w/o dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material","date_of_service":"2026-05-10","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":"L3966","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78730","name":"Urinary bladder retention","description":"Urinary bladder residual study (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5020","name":"Tibial tubercle hgt w/ toe f","description":"Partial foot, molded socket, tibial tubercle height, with toe filler","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41510","name":"Tongue to lip surgery","description":"Suture of tongue to lip for micrognathia (douglas type procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"84703","name":"Chorionic gonadotropin assay","description":"Gonadotropin, chorionic (hcg); qualitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q0486","name":"Mon cable elec/pneum vad rep","description":"Monitor control cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35701","name":"Expl n/flwd surg neck art","description":"Exploration not followed by surgical repair, artery; neck (eg, carotid, subclavian)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J0215","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2112","name":"Spherocylindr 7.25d/2.25-4d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"61698","name":"Brain aneurysm repr complx","description":"Surgery of complex intracranial aneurysm, intracranial approach; vertebrobasilar circulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67120","name":"Remove eye implant material","description":"Removal of implanted material, posterior segment; extraocular","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":403.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7029","name":"Repl nasal pillow comb mask","description":"Nasal pillows for combination oral/nasal mask, replacement only, pair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6011","name":"Collagen gel/paste wound fil","description":"Collagen based wound filler, gel/paste, per gram of collagen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0309","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1042.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0167","name":"Commode chair pail or pan","description":"Pail or pan for use with commode chair, replacement only","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"86331","name":"Immunodiffusion ouchterlony","description":"Immunodiffusion; gel diffusion, qualitative (ouchterlony), each antigen or antibody","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":949.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"75978","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87164","name":"Dark field exam spec collj","description":"Dark field examination, any source (eg, penile, vaginal, oral, skin); includes specimen collection","date_of_service":"2026-05-10","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":"70160","name":"X-ray exam of nasal bones","description":"Radiologic examination, nasal bones, complete, minimum of 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1335.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1301.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1265","name":"Dopamine injection","description":"Injection, dopamine hcl, 40 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1028.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1550","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-10","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":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":835.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"51792","name":"Urinary reflex study","description":"Stimulus evoked response (eg, measurement of bulbocavernosus reflex latency time)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"88239","name":"Tissue culture tumor","description":"Tissue culture for neoplastic disorders; solid tumor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6231","name":"Hydrogel dsg<=16 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"94680","name":"O2 uptk rst&xers dir simple","description":"Oxygen uptake, expired gas analysis; rest and exercise, direct, simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24370","name":"Revise reconst elbow joint","description":"Revision of total elbow arthroplasty, including allograft when performed; humeral or ulnar component","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1312.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70310","name":"X-ray exam of teeth","description":"Radiologic examination, teeth; partial examination, less than full mouth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71034","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"28510","name":"Treatment of toe fracture","description":"Closed treatment of fracture, phalanx or phalanges, other than great toe; without manipulation, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95869","name":"Ndl emg thrc paraspinal musc","description":"Needle electromyography; thoracic paraspinal muscles (excluding t1 or t12)","date_of_service":"2026-05-10","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":"E1038","name":"Transport chair pt wt<=300lb","description":"Transport chair, adult size, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6915","name":"Hand restoration replacmnt g","description":"Hand restoration (shading, and measurements included), replacement glove for above","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":795.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52441","name":"Cysto insj trnsprstc 1 implt","description":"Cystourethroscopy, with insertion of permanent adjustable transprostatic implant; single implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1466.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0249","name":"Pad water circulating heat u","description":"Pad for water circulating heat unit, for replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6584","name":"Elbow fair lead cable molded","description":"Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":701.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00912","name":"Anes trurl px rescj bldr tum","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of bladder tumor(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0297","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"00880","name":"Anes maj lwr abd vessel nos","description":"Anesthesia for procedures on major lower abdominal vessels; not otherwise specified","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":364.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0424","name":"Stationary compressed gas 02","description":"Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5081","name":"Stoma plug or seal, any type","description":"Stoma plug or seal, any type","date_of_service":"2026-05-10","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":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"73551","name":"X-ray exam of femur 1","description":"Radiologic examination, femur; 1 view","date_of_service":"2026-05-10","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":"77600","name":"Hyperthermia ext gen supfc","description":"Hyperthermia, externally generated; superficial (ie, heating to a depth of 4 cm or less)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":527.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2435.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0483","name":"Hi freq chest wall oscil sys","description":"High frequency chest wall oscillation system, with full anterior and/or posterior thoracic region receiving simultaneous external oscillation, includes all accessories and supplies, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2101","name":"Bld glucose monitor w lance","description":"Blood glucose monitor with integrated lancing/blood sample","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-05-10","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":"52332","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with insertion of indwelling ureteral stent (eg, gibbons or double-j type)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"58293","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"99336","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0953","name":"W/c lateral thigh/knee sup","description":"Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"61345","name":"Oth cranial dcmprn pst fossa","description":"Other cranial decompression, posterior fossa","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2281.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"30560","name":"Lysis intranasal synechia","description":"Lysis intranasal synechia","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5501","name":"Diabetic custom molded shoe","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patients foot (custom molded shoe), per shoe","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":62.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1078.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2916.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1625.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2839.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["TC"]}],"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":"2026-05-10","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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":936.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":912.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"32554","name":"Aspirate pleura w/o imaging","description":"Thoracentesis, needle or catheter, aspiration of the pleural space; without imaging guidance","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4545","name":"Suppl accessor tibial stim","description":"Supplies and accessories for external tibial nerve stimulator (e.g., socks, gel pads, electrodes, etc.), needed for one month","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4047","name":"Cast sup sht leg splnt ped p","description":"Cast supplies, short leg splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0736","name":"Transcut tibial nerv stimula","description":"Transcutaneous tibial nerve stimulator","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"15570","name":"Skin pedicle flap trunk","description":"Formation of direct or tubed pedicle, with or without transfer; trunk","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01380","name":"Anes all clsd px knee joint","description":"Anesthesia for all closed procedures on knee joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1083.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L1945","name":"Afo molded plas rig ant tib","description":"Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated","date_of_service":"2026-05-10","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":"72126","name":"Ct neck spine w/dye","description":"Computed tomography, cervical spine; with contrast material","date_of_service":"2026-05-10","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":"96445","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82104","name":"Alpha-1-antitrypsin pheno","description":"Alpha-1-antitrypsin; phenotype","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"68130","name":"Exc les conjunctiva adj scl","description":"Excision of lesion, conjunctiva; with adjacent sclera","date_of_service":"2026-05-10","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":"E0457","name":"Chest shell","description":"Chest shell (cuirass)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78000","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"90744","name":"Hepb vacc 3 dose ped/adol im","description":"Hepatitis b vaccine (hepb), pediatric/adolescent dosage, 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","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":33.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99407","name":"Behav chng smoking > 10 min","description":"Smoking and tobacco use cessation counseling visit; intensive, greater than 10 minutes","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"B9006","name":"Parenteral infus pump statio","description":"Parenteral nutrition infusion pump, stationary","date_of_service":"2026-05-10","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":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"90809","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90672","name":"Laiv4 vaccine intranasal","description":"Influenza virus vaccine, quadrivalent, live (laiv4), for intranasal use","date_of_service":"2026-05-10","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":27.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":472.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":523.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28545","name":"Treat foot dislocation","description":"Closed treatment of tarsal bone dislocation, other than talotarsal; requiring anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"86674","name":"Giardia lamblia antibody","description":"Antibody; giardia lamblia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27591","name":"Amputate leg at thigh","description":"Amputation, thigh, through femur, any level; immediate fitting technique including first cast","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51080","name":"Drainage of bladder abscess","description":"Drainage of perivesical or prevesical space abscess","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88347","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35633","name":"Bpg ilio-mesenteric","description":"Bypass graft, with other than vein; ilio-mesenteric","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2206","name":"Lens sphcy bifocal 4.00d/ove","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2211","name":"Pneumatic propulsion tire","description":"Manual wheelchair accessory, pneumatic propulsion tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20220","name":"Bone biopsy trocar/ndl supfc","description":"Biopsy, bone, trocar, or needle; superficial (eg, ilium, sternum, spinous process, ribs)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"91122","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76010","name":"X-ray nose to rectum","description":"Radiologic examination from nose to rectum for foreign body, single view, child","date_of_service":"2026-05-10","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":"76496","name":"Unlisted fluoroscopic px","description":"Unlisted fluoroscopic procedure (eg, diagnostic, interventional)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":"77762","name":"Apply intrcav radiat interm","description":"Intracavitary radiation source application; intermediate","date_of_service":"2026-05-10","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":"A4671","name":"Disposable cycler set","description":"Disposable cycler set used with cycler dialysis machine, each","date_of_service":"2026-05-10","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":"27598","name":"Amputate lower leg at knee","description":"Disarticulation at knee","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42800","name":"Biopsy of throat","description":"Biopsy; oropharynx","date_of_service":"2026-05-10","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":"76604","name":"Us exam chest","description":"Ultrasound, chest (includes mediastinum), real time with image documentation","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"54050","name":"Destruction penis lesion(s)","description":"Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; chemical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64626","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":240.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27158","name":"Revision of pelvis","description":"Osteotomy, pelvis, bilateral (eg, congenital malformation)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1188.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1690","name":"Combination bilateral ho","description":"Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"89140","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"92585","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90473","name":"Immune admin oral/nasal","description":"Immunization administration by intranasal or oral route; 1 vaccine (single or combination vaccine/toxoid)","date_of_service":"2026-05-10","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":"33030","name":"Partial removal of heart sac","description":"Pericardiectomy, subtotal or complete; without cardiopulmonary bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1736.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86658","name":"Enterovirus antibody","description":"Antibody; enterovirus (eg, coxsackie, echo, polio)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0327","name":"Colon ca scrn;bld-bsd biomrk","description":"Colorectal cancer screening; blood-based biomarker","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"15756","name":"Free myo/skin flap microvasc","description":"Free muscle or myocutaneous flap with microvascular anastomosis","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2430","name":"Knee jnt ratchet lock ea jnt","description":"Addition to knee joint, ratchet lock for active and progressive knee extension, each joint","date_of_service":"2026-05-10","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":"01962","name":"Anes urgent hysterectomy","description":"Anesthesia for urgent hysterectomy following delivery","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"62121","name":"Incise skull repair","description":"Craniotomy for repair of encephalocele, skull base","date_of_service":"2026-05-10","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":"G0328","name":"Fecal blood scrn immunoassay","description":"Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20200","name":"Muscle biopsy superficial","description":"Biopsy, muscle; superficial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27781","name":"Treatment of fibula fracture","description":"Closed treatment of proximal fibula or shaft fracture; with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4001","name":"Cast sup body cast plaster","description":"Casting supplies, body cast adult, with or without head, plaster","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"66160","name":"Glaucoma surgery","description":"Fistulization of sclera for glaucoma; sclerectomy with punch or scissors, with iridectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":930.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58520","name":"Repair of ruptured uterus","description":"Hysterorrhaphy, repair of ruptured uterus (nonobstetrical)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":866.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6237.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":743.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"C1768","name":"Graft, vascular","description":"Graft, vascular","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2192","name":"Pelvic band & belt thigh fla","description":"Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"0355T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"67900","name":"Repair brow defect","description":"Repair of brow ptosis (supraciliary, mid-forehead or coronal approach)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2303.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1171","name":"Wheelchair amputee w/o leg r","description":"Amputee wheelchair, fixed full length arms, without footrests or legrest","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82247","name":"Bilirubin total","description":"Bilirubin; total","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-10","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":"E0860","name":"Tract equip cervical tract","description":"Traction equipment, overdoor, cervical","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"77054","name":"X-ray of mammary ducts","description":"Mammary ductogram or galactogram, multiple ducts, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72131","name":"Ct lumbar spine w/o dye","description":"Computed tomography, lumbar spine; without contrast material","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1204.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2182","name":"Drop lock knee","description":"Addition to lower extremity fracture orthosis, drop lock knee joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35645","name":"Bpg subclavian-vertebral","description":"Bypass graft, with other than vein; subclavian-vertebral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1264.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5826","name":"Miniature knee joint","description":"Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1818.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4648","name":"Implantable tissue marker","description":"Tissue marker, implantable, any type, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44005","name":"Freeing of bowel adhesion","description":"Enterolysis (freeing of intestinal adhesion) (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1113.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57505","name":"Endocervical curettage","description":"Endocervical curettage (not done as part of a dilation and curettage)","date_of_service":"2026-05-10","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":"G6025","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49013","name":"Prpertl pel pack hemrrg trma","description":"Preperitoneal pelvic packing for hemorrhage associated with pelvic trauma, including local exploration","date_of_service":"2026-05-10","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":"62120","name":"Repair skull cavity lesion","description":"Repair of encephalocele, skull vault, including cranioplasty","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2023.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27740","name":"Repair of leg epiphyses","description":"Arrest, epiphyseal (epiphysiodesis), any method, combined, proximal and distal tibia and fibula;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":597.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43850","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1368.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43269","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2310","name":"Lens sphc trifocal 4.25-7/>6","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1093.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"78579","name":"Lung ventilation imaging","description":"Pulmonary ventilation imaging (eg, aerosol or gas)","date_of_service":"2026-05-10","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":"28110","name":"Part removal of metatarsal","description":"Ostectomy, partial excision, fifth metatarsal head (bunionette) (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":354.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22849","name":"Reinsert spinal fixation","description":"Reinsertion of spinal fixation device","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1562.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33861","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2469.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67005","name":"Partial removal of eye fluid","description":"Removal of vitreous, anterior approach (open sky technique or limbal incision); partial removal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4338","name":"Indwelling catheter latex","description":"Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each","date_of_service":"2026-05-10","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":"E0230","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37195","name":"Thrombolytic therapy stroke","description":"Thrombolysis, cerebral, by intravenous infusion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"31775","name":"Reconstruct bronchus","description":"Bronchoplasty; excision stenosis and anastomosis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1117.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6300","name":"Shlder disart int lock elbow","description":"Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"99220","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0941","name":"Gravity assisted traction de","description":"Gravity assisted traction device, any type","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J9001","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2128.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0149","name":"Heavy duty wheeled walker","description":"Walker, heavy duty, wheeled, rigid or folding, any type","date_of_service":"2026-05-10","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":"27310","name":"Exploration of knee joint","description":"Arthrotomy, knee, with exploration, drainage, or removal of foreign body (eg, infection)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E0574","name":"Ultrasonic generator w svneb","description":"Ultrasonic/electronic aerosol generator with small volume nebulizer","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76375","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"95974","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95869","name":"Ndl emg thrc paraspinal musc","description":"Needle electromyography; thoracic paraspinal muscles (excluding t1 or t12)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0944","name":"Pelvic belt/harness/boot","description":"Pelvic belt/harness/boot","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27090","name":"Removal of hip prosthesis","description":"Removal of hip prosthesis; (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":703.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","date_of_service":"2026-05-10","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":"35881","name":"Revise graft w/vein","description":"Revision, lower extremity arterial bypass, without thrombectomy, open; with segmental vein interposition","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1533.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"73580","name":"Contrast x-ray of knee joint","description":"Radiologic examination, knee, arthrography, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2306","name":"Lens sphcyl trifocal 4.00/>6","description":"Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"77075","name":"Radex osseous survey compl","description":"Radiologic examination, osseous survey; complete (axial and appendicular skeleton)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4389","name":"Drainable pch w st wear barr","description":"Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"50920","name":"Closure ureter/skin fistula","description":"Closure of ureterocutaneous fistula","date_of_service":"2026-05-10","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":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","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":"33020","name":"Incision of heart sac","description":"Pericardiotomy for removal of clot or foreign body (primary procedure)","date_of_service":"2026-05-10","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":"30468","name":"Rpr nsl vlv collapse w/implt","description":"Repair of nasal valve collapse with subcutaneous/submucosal lateral wall implant(s)","date_of_service":"2026-05-10","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":"G0328","name":"Fecal blood scrn immunoassay","description":"Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-05-10","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":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":775.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"C1753","name":"Cath, intravas ultrasound","description":"Catheter, intravascular ultrasound","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82533","name":"Total cortisol","description":"Cortisol; total","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"00522","name":"Anes clsd ch px ndl bx pleur","description":"Anesthesia for closed chest procedures; needle biopsy of pleura","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72265","name":"Myelography l-s spine","description":"Myelography, lumbosacral, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0439","name":"Stationary liquid 02","description":"Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"H0001","name":"Alcohol and/or drug assess","description":"Alcohol and/or drug assessment","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1240.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2543.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"25450","name":"Epiphysl arrst dstl rds/ulna","description":"Epiphyseal arrest by epiphysiodesis or stapling; distal radius or ulna","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7190","name":"Factor viii","description":"Factor viii (antihemophilic factor, human) per i.u.","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1800","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25680","name":"Cltx trns-scphprlnr fx mnpj","description":"Closed treatment of trans-scaphoperilunar type of fracture dislocation, with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":440.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7502","name":"Replacement diaphragm/fplate","description":"Replacement diaphragm/faceplate for tracheostoma valve, each","date_of_service":"2026-05-10","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":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","date_of_service":"2026-05-10","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":"V2630","name":"Anter chamber intraocul lens","description":"Anterior chamber intraocular lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1256.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61070","name":"Brain canal shunt procedure","description":"Puncture of shunt tubing or reservoir for aspiration or injection procedure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"86603","name":"Adenovirus antibody","description":"Antibody; adenovirus","date_of_service":"2026-05-10","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":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"74329","name":"X-ray for pancreas endoscopy","description":"Endoscopic catheterization of the pancreatic ductal system, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L6110","name":"Elbow mold sock suspension t","description":"Below elbow, molded socket, (muenster or northwestern suspension types)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KC"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":216.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"82306","name":"Vitamin d 25 hydroxy","description":"Vitamin d; 25 hydroxy, includes fraction(s), if performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01999","name":"Unlisted anes procedure","description":"Unlisted anesthesia procedure(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.26,"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":622.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33282","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["BA","UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3775.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"C1300","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50320","name":"Remove kidney living donor","description":"Donor nephrectomy (including cold preservation); open, from living donor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1561.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1124.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":608.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70134","name":"X-ray exam of middle ear","description":"Radiologic examination, internal auditory meati, complete","date_of_service":"2026-05-10","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":"32854","name":"Lung transplant with bypass","description":"Lung transplant, double (bilateral sequential or en bloc); with cardiopulmonary bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3934.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0672","name":"Pressure pneum appl full arm","description":"Segmental gradient pressure pneumatic appliance, full arm","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"43832","name":"Gstrst open w/constj tube","description":"Gastrostomy, open; with construction of gastric tube (eg, janeway procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1084.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1465.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"Q0502","name":"Mobility cart pneum vad, rep","description":"Mobility cart for pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"23180","name":"Prtl excision bone clavicle","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), clavicle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2785.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"37700","name":"Ligation&div long saph vein","description":"Ligation and division of long saphenous vein at saphenofemoral junction, or distal interruptions","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":318.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71060","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4624","name":"Tracheal suction tube","description":"Tracheal suction catheter, any type other than closed system, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78601","name":"Brain image w/flow < 4 views","description":"Brain imaging, less than 4 static views; with vascular flow","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1120.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4042","name":"Cast sup lng leg splnt fbrgl","description":"Cast supplies, long leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45172","name":"Exc rect tum transanal full","description":"Excision of rectal tumor, transanal approach; including muscularis propria (ie, full thickness)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28735","name":"Fusion of foot bones","description":"Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse; with osteotomy (eg, flatfoot correction)","date_of_service":"2026-05-10","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":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-10","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":"E1808","name":"Adjust wrist flexion device","description":"Dynamic adjustable wrist flexion only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35372","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; deep (profunda) femoral","date_of_service":"2026-05-10","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":"93232","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35301","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; carotid, vertebral, subclavian, by neck incision","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7036","name":"Pos airway press chinstrap","description":"Chinstrap used with positive airway pressure device","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"30150","name":"Rhinectomy partial","description":"Rhinectomy; partial","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":629.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"45123","name":"Partial proctectomy","description":"Proctectomy, partial, without anastomosis, perineal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1122.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0738","name":"Upper extremity rehab","description":"Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, include microprocessor, all components and accessories","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"01654","name":"Anes art sho&ax bypass grf","description":"Anesthesia for procedures on arteries of shoulder and axilla; bypass graft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6238","name":"Hydrocolld drg >16<=48 w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88106","name":"Cytopath fl nongyn filter","description":"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0482","name":"Microprcsr cu combo vad, rep","description":"Microprocessor control unit for use with electric/pneumatic combination ventricular assist device, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"Q4025","name":"Cast sup hip spica plaster","description":"Cast supplies, hip spica (one or both legs), adult (11 years +), plaster","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"29345","name":"Application of long leg cast","description":"Application of long leg cast (thigh to toes);","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1872.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"69502","name":"Mastoidectomy","description":"Mastoidectomy; complete","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":770.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8623","name":"Lith ion batt cid,non-earlvl","description":"Lithium ion battery for use with cochlear implant device speech processor, other than ear level, replacement, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1411.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3808","name":"Whfo, rigid w/o joints","description":"Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","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":"75957","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":671.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7030","name":"Cpap full face mask","description":"Full face mask used with positive airway pressure device, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40801","name":"Drainage of mouth lesion","description":"Drainage of abscess, cyst, hematoma, vestibule of mouth; complicated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80202","name":"Assay of vancomycin","description":"Vancomycin","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93978","name":"Vascular study","description":"Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; complete study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":271.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2785","name":"Drop lock retainer each","description":"Addition to lower extremity orthosis, drop lock retainer, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5828","name":"Endo knee-shin fluid swg/sta","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0880","name":"Trac stand free stand extrem","description":"Traction stand, free standing, extremity traction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4416","name":"Ost pch clsd w barrier/filtr","description":"Ostomy pouch, closed, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4417","name":"Ost pch w bar/bltinconv/fltr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"74425","name":"Urography antegrade rs&i","description":"Urography, antegrade, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"A4398","name":"Ostomy irrigation bag","description":"Ostomy irrigation supply; bag, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E0572","name":"Aerosol compressor adjust pr","description":"Aerosol compressor, adjustable pressure, light duty for intermittent use","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"69110","name":"Remove external ear partial","description":"Excision external ear; partial, simple repair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":375.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"27781","name":"Treatment of fibula fracture","description":"Closed treatment of proximal fibula or shaft fracture; with manipulation","date_of_service":"2026-05-10","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":"88245","name":"Chromosome analysis 20-25","description":"Chromosome analysis for breakage syndromes; baseline sister chromatid exchange (sce), 20-25 cells","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"01782","name":"Anes vn upr arm&elbw phlbrpy","description":"Anesthesia for procedures on veins of upper arm and elbow; phleborrhaphy","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83907","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"65920","name":"Remove implant of eye","description":"Removal of implanted material, anterior segment of eye","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86703","name":"Hiv-1/hiv-2 1 result antbdy","description":"Antibody; hiv-1 and hiv-2, single result","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71130","name":"X-ray strenoclavic jt 3/>vws","description":"Radiologic examination; sternoclavicular joint or joints, minimum of 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":728.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"93235","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A4500","name":"Below knee surgical stocking","description":"Surgical stockings below knee length, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"21082","name":"Impres&prep paltl aug prosth","description":"Impression and custom preparation; palatal augmentation prosthesis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"42335","name":"Removal of salivary stone","description":"Sialolithotomy; submandibular (submaxillary), complicated, intraoral","date_of_service":"2026-05-10","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":"61334","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"15775","name":"Hair trnspl 1-15 punch grfts","description":"Punch graft for hair transplant; 1 to 15 punch grafts","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26591","name":"Repair muscles of hand","description":"Repair, intrinsic muscles of hand, each muscle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6215","name":"Foam dressing wound filler","description":"Foam dressing, wound filler, sterile, per gram","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84484","name":"Assay of troponin quant","description":"Troponin, quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"11900","name":"Inject skin lesions </w 7","description":"Injection, intralesional; up to and including 7 lesions","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0820","name":"Pwc gp 2 std port seat/back","description":"Power wheelchair, group 2 standard, portable, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0630","name":"Patient lift hydraulic","description":"Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s)","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1743.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15361","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96921","name":"Excimer lsr psriasis 250-500","description":"Excimer laser treatment for psoriasis; 250 sq cm to 500 sq cm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"11980","name":"Implant hormone pellet(s)","description":"Subcutaneous hormone pellet implantation (implantation of estradiol and/or testosterone pellets beneath the skin)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"22525","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"42960","name":"Control throat bleeding","description":"Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); simple","date_of_service":"2026-05-10","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":"58671","name":"Laparoscopy tubal block","description":"Laparoscopy, surgical; with occlusion of oviducts by device (eg, band, clip, or falope ring)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":426.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"49321","name":"Laparoscopy biopsy","description":"Laparoscopy, surgical; with biopsy (single or multiple)","date_of_service":"2026-05-10","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":"84106","name":"Test for porphobilinogen","description":"Porphobilinogen, urine; qualitative","date_of_service":"2026-05-10","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":"Q0496","name":"Battery elec/combo vad, rep","description":"Battery, other than lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":730.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"31755","name":"Trachplsty trchphryngl fstlj","description":"Tracheoplasty; tracheopharyngeal fistulization, each stage","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1290.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"64573","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":655.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"27560","name":"Treat kneecap dislocation","description":"Closed treatment of patellar dislocation; without anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":370.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6584","name":"Elbow fair lead cable molded","description":"Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1907","name":"Afo supramalleolar custom","description":"Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4640","name":"Alternating pressure pad","description":"Replacement pad for use with medically necessary alternating pressure pad owned by patient","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75860","name":"Vein x-ray neck","description":"Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62310","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"L6935","name":"Below elbow myoelectronic ct","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24351","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":588.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92507","name":"Tx sp lang voice comm indiv","description":"Treatment of speech, language, voice, communication, and/or auditory processing disorder; individual","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"84577","name":"Assay of feces/urobilinogen","description":"Urobilinogen, feces, quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"31032","name":"Explore sinus remove polyps","description":"Sinusotomy, maxillary (antrotomy); radical (caldwell-luc) with removal of antrochoanal polyps","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1731.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":911.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-10","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":"35201","name":"Repair blood vessel dir neck","description":"Repair blood vessel, direct; neck","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":820.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95955","name":"Eeg during surgery","description":"Electroencephalogram (eeg) during nonintracranial surgery (eg, carotid surgery)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74360","name":"X-ray guide gi dilation","description":"Intraluminal dilation of strictures and/or obstructions (eg, esophagus), radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"31775","name":"Reconstruct bronchus","description":"Bronchoplasty; excision stenosis and anastomosis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1117.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2975.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1751","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73610","name":"X-ray exam of ankle","description":"Radiologic examination, ankle; complete, minimum of 3 views","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"33926","name":"Repr pul art unifocal w/cpb","description":"Repair of pulmonary artery arborization anomalies by unifocalization; with cardiopulmonary bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2953.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5634","name":"Symes type poster opening so","description":"Addition to lower extremity, symes type, posterior opening (canadian) socket","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"1159F","name":"Med list docd in rcrd","description":"Medication list documented in medical record (coa)","date_of_service":"2026-05-10","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":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"78010","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43651","name":"Laparoscopy vagus nerve","description":"Laparoscopy, surgical; transection of vagus nerves, truncal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8688","name":"Implt nrostm pls gen dua non","description":"Implantable neurostimulator pulse generator, dual array, non-rechargeable, includes extension","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11010","name":"Debride skin at fx site","description":"Debridement including removal of foreign material at the site of an open fracture and/or an open dislocation (eg, excisional debridement); skin and subcutaneous tissues","date_of_service":"2026-05-10","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":"78075","name":"Adrenal cortex & medulla img","description":"Adrenal imaging, cortex and/or medulla","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28270","name":"Release of foot contracture","description":"Capsulotomy; metatarsophalangeal joint, with or without tenorrhaphy, each joint (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2395","name":"Offset knee joint heavy duty","description":"Addition to lower extremity, offset knee joint, heavy duty, each joint","date_of_service":"2026-05-10","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":"44403","name":"Colonoscopy w/resection","description":"Colonoscopy through stoma; with endoscopic mucosal resection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73701","name":"Ct lower extremity w/dye","description":"Computed tomography, lower extremity; with contrast material(s)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"L3916","name":"Who nontorsion jnts pre ots","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21600","name":"Partial removal of rib","description":"Excision of rib, partial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":420.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"A6550","name":"Neg pres wound ther drsg set","description":"Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"87252","name":"Virus inoculation tissue","description":"Virus isolation; tissue culture inoculation, observation, and presumptive identification by cytopathic effect","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"35701","name":"Expl n/flwd surg neck art","description":"Exploration not followed by surgical repair, artery; neck (eg, carotid, subclavian)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":663.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21800","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"35548","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33910","name":"Remove lung artery emboli","description":"Pulmonary artery embolectomy; with cardiopulmonary bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1779.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68530","name":"Clearance of tear duct","description":"Removal of foreign body or dacryolith, lacrimal passages","date_of_service":"2026-05-10","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":"27268","name":"Cltx thigh fx w/mnpj","description":"Closed treatment of femoral fracture, proximal end, head; with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37204","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55650","name":"Remove sperm duct pouch","description":"Vesiculectomy, any approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15941","name":"Exc isch pr ulc prm sut ostc","description":"Excision, ischial pressure ulcer, with primary suture; with ostectomy (ischiectomy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1022.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q0497","name":"Bat clps elec/comb vad, rep","description":"Battery clips for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"50396","name":"Measure kidney pressure","description":"Manometric studies through nephrostomy or pyelostomy tube, or indwelling ureteral catheter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"L8607","name":"Inj vocal cord bulking agent","description":"Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"31200","name":"Removal of ethmoid sinus","description":"Ethmoidectomy; intranasal, anterior","date_of_service":"2026-05-10","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":"85060","name":"Blood smear interpretation","description":"Blood smear, peripheral, interpretation by physician with written report","date_of_service":"2026-05-10","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":"91120","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75724","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1136.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6528","name":"G com garment bra nighttime","description":"Gradient compression garment, bra, for nighttime use, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1083.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73560","name":"X-ray exam of knee 1 or 2","description":"Radiologic examination, knee; 1 or 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5926","name":"Endoskel posit rotat unit","description":"Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","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":"51841","name":"Attach bladder/urethra","description":"Anterior vesicourethropexy, or urethropexy (eg, marshall-marchetti-krantz, burch); complicated (eg, secondary repair)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43194","name":"Esophagoscp rig trnso rem fb","description":"Esophagoscopy, rigid, transoral; with removal of foreign body(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6219","name":"Gauze <= 16 sq in w/border","description":"Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":561.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53450","name":"Revision of urethra","description":"Urethromeatoplasty, with mucosal advancement","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"94720","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"29220","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0630","name":"Lso r post pnl sj-t9 pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6880","name":"Elec hand ind art digits","description":"Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2523","name":"Cntct lens hydrophil extend","description":"Contact lens, hydrophilic, extended wear, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33315","name":"Exploratory heart surgery","description":"Cardiotomy, exploratory (includes removal of foreign body, atrial or ventricular thrombus); with cardiopulmonary bypass","date_of_service":"2026-05-10","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":"87260","name":"Adenovirus ag if","description":"Infectious agent antigen detection by immunofluorescent technique; adenovirus","date_of_service":"2026-05-10","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":"91132","name":"Electrogastrography","description":"Electrogastrography, diagnostic, transcutaneous;","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"83904","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"27580","name":"Fusion of knee","description":"Arthrodesis, knee, any technique","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49565","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"63198","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2000","name":"Gastric suction pump hme mdl","description":"Gastric suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"35526","name":"Art byp grft aor/carot/innom","description":"Bypass graft, with vein; aortosubclavian, aortoinnominate, or aortocarotid","date_of_service":"2026-05-10","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":"51065","name":"Remove ureter calculus","description":"Cystotomy, with calculus basket extraction and/or ultrasonic or electrohydraulic fragmentation of ureteral calculus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"94728","name":"Airwy resist by oscillometry","description":"Airway resistance by oscillometry","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"27052","name":"Biopsy of hip joint","description":"Arthrotomy, with biopsy; hip joint","date_of_service":"2026-05-10","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":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A7000","name":"Disposable canister for pump","description":"Canister, disposable, used with suction pump, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KN"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"76831","name":"Echo exam uterus","description":"Saline infusion sonohysterography (sis), including color flow doppler, when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0862","name":"Pwc gp3 hd mult pow opt s/b","description":"Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":"82656","name":"El-1 fecal qual/semiq","description":"Elastase, pancreatic (el-1), fecal; qualitative or semi-quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3786.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-10","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":"78579","name":"Lung ventilation imaging","description":"Pulmonary ventilation imaging (eg, aerosol or gas)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["AU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":822.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28226","name":"Release of foot tendons","description":"Tenolysis, extensor, foot; multiple tendons","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"74415","name":"Urography nfs drip&/bls w/nf","description":"Urography, infusion, drip technique and/or bolus technique; with nephrotomography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2375","name":"Torsion ank & half solid sti","description":"Addition to lower extremity, torsion control, ankle joint and half solid stirrup","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01682","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74485","name":"Dilation urtr/urt rs&i","description":"Dilation of ureter(s) or urethra, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"E0256","name":"Hospital bed var ht w/o matt","description":"Hospital bed, variable height, hi-lo, with any type side rails, without mattress","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"64744","name":"Incise nerve back of head","description":"Transection or avulsion of; greater occipital nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":464.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73592","name":"X-ray exam of leg infant","description":"Radiologic examination; lower extremity, infant, minimum of 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0984","name":"Add pwr tiller","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84155","name":"Assay of protein serum","description":"Protein, total, except by refractometry; serum, plasma or whole blood","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43825","name":"Gastrojejunostomy w/vagotomy","description":"Gastrojejunostomy; with vagotomy, any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78812","name":"Pet image skull-thigh","description":"Positron emission tomography (pet) imaging; skull base to mid-thigh","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88173","name":"Cytopath eval fna report","description":"Cytopathology, evaluation of fine needle aspirate; interpretation and report","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"81050","name":"Urinalysis volume measure","description":"Volume measurement for timed collection, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0562","name":"Humidifier heated used w pap","description":"Humidifier, heated, used with positive airway pressure device","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"E1295","name":"Wheelchair heavy duty fixed","description":"Heavy duty wheelchair, fixed full length arms, elevating legrest","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"85651","name":"Rbc sed rate nonautomated","description":"Sedimentation rate, erythrocyte; non-automated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5920","name":"Endo ak/hip alignable system","description":"Addition, endoskeletal system, above knee or hip disarticulation, alignable system","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":331.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":772.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["QW","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35188","name":"Rpr acq av fistula head&neck","description":"Repair, acquired or traumatic arteriovenous fistula; head and neck","date_of_service":"2026-05-10","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":"70332","name":"X-ray exam of jaw joint","description":"Temporomandibular joint arthrography, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"A7017","name":"Nebulizer not used w oxygen","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":"J1590","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"84466","name":"Assay of transferrin","description":"Transferrin","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"73085","name":"Contrast x-ray of elbow","description":"Radiologic examination, elbow, arthrography, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31805","name":"Repair of windpipe injury","description":"Suture of tracheal wound or injury; intrathoracic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":995.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":"21280","name":"Medial canthopexy","description":"Medial canthopexy (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":458.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95900","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"64760","name":"Incision of vagus nerve","description":"Transection or avulsion of; vagus nerve (vagotomy), abdominal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67112","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77305","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86327","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"29897","name":"Ankle arthroscopy/surgery","description":"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, limited","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38542","name":"Explore deep node(s) neck","description":"Dissection, deep jugular node(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36597","name":"Reposition venous catheter","description":"Repositioning of previously placed central venous catheter under fluoroscopic guidance","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"85475","name":"Hemolysin acid","description":"Hemolysin, acid","date_of_service":"2026-05-10","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":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"45540","name":"Correct rectal prolapse","description":"Proctopexy (eg, for prolapse); abdominal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1101.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46934","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51000","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99431","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85240","name":"Clot factor viii ahg 1 stage","description":"Clotting; factor viii (ahg), 1-stage","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L3763","name":"Ewho rigid w/o jnts cf","description":"Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"Q0484","name":"Monitor elec or comb vad rep","description":"Monitor/display module for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"74425","name":"Urography antegrade rs&i","description":"Urography, antegrade, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6691","name":"Removable insert each","description":"Upper extremity addition, removable insert, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"40654","name":"Rpr lip fth>1half ver ht/cpx","description":"Repair lip, full thickness; over one-half vertical height, or complex","date_of_service":"2026-05-10","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":"78216","name":"Lvr&spleen img w/vasc flow","description":"Liver and spleen imaging; with vascular flow","date_of_service":"2026-05-10","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":"50392","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65600","name":"Revision of cornea","description":"Multiple punctures of anterior cornea (eg, for corneal erosion, tattoo)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"45900","name":"Reduction of rectal prolapse","description":"Reduction of procidentia (separate procedure) under anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4380","name":"Urinary rubber pouch w fcplt","description":"Ostomy pouch, urinary, with faceplate attached, rubber, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4413","name":"2 pc drainable ost pouch","description":"Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), with filter, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4356","name":"Ext ureth clmp or compr dvc","description":"External urethral clamp or compression device (not to be used for catheter clamp), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"L4350","name":"Ankle control ortho pre ots","description":"Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":"27590","name":"Amputate leg at thigh","description":"Amputation, thigh, through femur, any level;","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2121","name":"Lenticular lens, single","description":"Lenticular lens, per lens, single","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7507","name":"Integrated filter & holder","description":"Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3923","name":"Hfo without joints pre cst","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"35901","name":"Excision graft neck","description":"Excision of infected graft; neck","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58661","name":"Laparoscopy remove adnexa","description":"Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":778.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0456","name":"Tlso flex trnk sj-ss pre cst","description":"Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on t","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45990","name":"Surg dx exam anorectal","description":"Anorectal exam, surgical, requiring anesthesia (general, spinal, or epidural), diagnostic","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43192","name":"Esophagoscp rig trnso inject","description":"Esophagoscopy, rigid, transoral; with directed submucosal injection(s), any substance","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"86695","name":"Herpes simplex type 1 test","description":"Antibody; herpes simplex, type 1","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30540","name":"Rpr choanal atresia ntranasl","description":"Repair choanal atresia; intranasal","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0275","name":"Bed pan standard","description":"Bed pan, standard, metal or plastic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00622","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"67015","name":"Release of eye fluid","description":"Aspiration or release of vitreous, subretinal or choroidal fluid, pars plana approach (posterior sclerotomy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0120","name":"Cerv flex n/adj foam pre ots","description":"Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)","date_of_service":"2026-05-10","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":"E0290","name":"Hosp bed fx ht w/o rails w/m","description":"Hospital bed, fixed height, without side rails, with mattress","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94060","name":"Evaluation of wheezing","description":"Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J2800","name":"Methocarbamol injection","description":"Injection, methocarbamol, up to 10 ml","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25310","name":"Transplant forearm tendon","description":"Tendon transplantation or transfer, flexor or extensor, forearm and/or wrist, single; each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1033.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2530","name":"Thigh/wght bear lacer non-mo","description":"Addition to lower extremity, thigh-weight bearing, lacer, non-molded","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5600","name":"Hip disart sach laminat mold","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"84233","name":"Assay of estrogen","description":"Receptor assay; estrogen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58800","name":"Drainage of ovarian cyst(s)","description":"Drainage of ovarian cyst(s), unilateral or bilateral (separate procedure); vaginal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77414","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"35495","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1187.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"51960","name":"Revision of bladder & bowel","description":"Enterocystoplasty, including intestinal anastomosis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1496.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"53515","name":"Repair of urethra injury","description":"Urethrorrhaphy, suture of urethral wound or injury; prostatomembranous","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4235","name":"Lithium batt for glucose mon","description":"Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KL","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":"2026-05-10","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":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","date_of_service":"2026-05-10","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":"57020","name":"Colpocentesis sep px","description":"Colpocentesis (separate procedure)","date_of_service":"2026-05-10","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":"65600","name":"Revision of cornea","description":"Multiple punctures of anterior cornea (eg, for corneal erosion, tattoo)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27392","name":"Incision of thigh tendons","description":"Tenotomy, open, hamstring, knee to hip; multiple tendons, bilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":838.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1039","name":"Transport chair pt wt >300lb","description":"Transport chair, adult size, heavy duty, patient weight capacity greater than 300 pounds","date_of_service":"2026-05-10","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":"A7040","name":"One way chest drain valve","description":"One way chest drain valve","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"A4368","name":"Ostomy filter","description":"Ostomy filter, any type, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"93303","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; complete","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2108","name":"Spherocylinder 4.25d/2.12-4d","description":"Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93005","name":"Electrocardiogram tracing","description":"Electrocardiogram, routine ecg with at least 12 leads; tracing only, without interpretation and report","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25151","name":"Partial removal of radius","description":"Partial excision (craterization, saucerization, or diaphysectomy) of bone (eg, for osteomyelitis); radius","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41510","name":"Tongue to lip surgery","description":"Suture of tongue to lip for micrognathia (douglas type procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":530.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0857","name":"Pwc gp3 std sing pow opt cap","description":"Power wheelchair, group 3 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":237.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"K0814","name":"Pwc gp 1 std port cap chair","description":"Power wheelchair, group 1 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99241","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0500","name":"Filters elec/combo vad, rep","description":"Filters for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"84154","name":"Assay of psa free","description":"Prostate specific antigen (psa); free","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"43211","name":"Esophagoscop mucosal resect","description":"Esophagoscopy, flexible, transoral; with endoscopic mucosal resection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":266.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43500","name":"Surgical opening of stomach","description":"Gastrotomy; with exploration or foreign body removal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78001","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55680","name":"Remove sperm pouch lesion","description":"Excision of mullerian duct cyst","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"82180","name":"Assay of ascorbic acid","description":"Ascorbic acid (vitamin c), blood","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"25929","name":"Amputation follow-up surgery","description":"Transmetacarpal amputation; secondary closure or scar revision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28750","name":"Fusion of big toe joint","description":"Arthrodesis, great toe; metatarsophalangeal joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8696","name":"Ext antenna phren nerve stim","description":"Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2760","name":"Scratch resistant coating","description":"Scratch resistant coating, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"E0433","name":"Portable liquid oxygen sys","description":"Portable liquid oxygen system, rental; home liquefier used to fill portable liquid oxygen containers, includes portable containers, regulator, flowmeter, humidifier, cannula or mask and tubing, with or without supply reservoir and contents gauge","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["QB","RR","QF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32422","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93971","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44970","name":"Laparoscopy appendectomy","description":"Laparoscopy, surgical, appendectomy","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"88346","name":"Imfluor 1st 1antb stain px","description":"Immunofluorescence, per specimen; initial single antibody stain procedure","date_of_service":"2026-05-10","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":"55812","name":"Extensive prostate surgery","description":"Prostatectomy, perineal radical; with lymph node biopsy(s) (limited pelvic lymphadenectomy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1301.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86615","name":"Bordetella antibody","description":"Antibody; bordetella","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":969.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2110","name":"Spherocylinder 4.25d/over 6d","description":"Spherocylinder, single vision, plus or minus 4.25 to 7.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6199","name":"Alginate drsg wound filler","description":"Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches","date_of_service":"2026-05-10","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":"L5705","name":"Custom shape cover ak","description":"Custom shaped protective cover, above knee","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q3025","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5150","name":"Mold sckt ext knee shin sach","description":"Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot","date_of_service":"2026-05-10","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":"L3219","name":"Orthopedic mens shoes oxford","description":"Orthopedic footwear, mens shoe, oxford, each","date_of_service":"2026-05-10","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":"21705","name":"Revision of neck muscle/rib","description":"Division of scalenus anticus; with resection of cervical rib","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":749.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0976","name":"Lso full corset","description":"Lso, full corset","date_of_service":"2026-05-10","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":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L0466","name":"Tlso r fram soft ant pre cst","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled,","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"31081","name":"Removal of frontal sinus","description":"Sinusotomy frontal; obliterative, without osteoplastic flap, coronal incision (includes ablation)","date_of_service":"2026-05-10","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":"35820","name":"Explore chest vessels","description":"Exploration for postoperative hemorrhage, thrombosis or infection; chest","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82985","name":"Assay of glycated protein","description":"Glycated protein","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"77784","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1376.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33286","name":"Rmvl subq car rhythm mntr","description":"Removal, subcutaneous cardiac rhythm monitor","date_of_service":"2026-05-10","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":"00532","name":"Anes access ctr venous crcj","description":"Anesthesia for access to central venous circulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"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":"2026-05-10","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":"76856","name":"Us exam pelvic complete","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84302","name":"Assay of sweat sodium","description":"Sodium; other source","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"44210","name":"Laparo total proctocolectomy","description":"Laparoscopy, surgical; colectomy, total, abdominal, without proctectomy, with ileostomy or ileoproctostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5503","name":"Diabetic shoe w/roller/rockr","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe","date_of_service":"2026-05-10","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":"E0290","name":"Hosp bed fx ht w/o rails w/m","description":"Hospital bed, fixed height, without side rails, with mattress","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0968","name":"Wheelchair commode seat","description":"Commode seat, wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"58700","name":"Removal of fallopian tube","description":"Salpingectomy, complete or partial, unilateral or bilateral (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":871.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2623","name":"Plastic eye prosth custom","description":"Prosthetic eye, plastic, custom","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":934.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75842","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-05-10","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":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","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":"69120","name":"Removal of external ear","description":"Excision external ear; complete amputation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"T4523","name":"Adult size brief/diaper lg","description":"Adult sized disposable incontinence product, brief/diaper, large, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2102","name":"Adju cgm receiver/monitor","description":"Adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KF"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":661.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":481.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"48400","name":"Injection intraop add-on","description":"Injection procedure for intraoperative pancreatography (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"50290","name":"Excision perinephric cyst","description":"Excision of perinephric cyst","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":726.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0760","name":"Osteogen ultrasound stimltor","description":"Osteogenesis stimulator, low intensity ultrasound, non-invasive","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77761","name":"Apply intrcav radiat simple","description":"Intracavitary radiation source application; simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":879.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0205","name":"Heat lamp with stand","description":"Heat lamp, with stand, includes bulb, or infrared element","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82306","name":"Vitamin d 25 hydroxy","description":"Vitamin d; 25 hydroxy, includes fraction(s), if performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4617","name":"Mouth piece","description":"Mouth piece","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0636","name":"Pt support & positioning sys","description":"Multipositional patient support system, with integrated lift, patient accessible controls","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"66920","name":"Extraction of lens","description":"Removal of lens material; intracapsular","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":735.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3420","name":"Vitamin b12 injection","description":"Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B4224","name":"Parenteral administration ki","description":"Parenteral nutrition administration kit, per day","date_of_service":"2026-05-10","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":"L5645","name":"Bk flex inner socket ext fra","description":"Addition to lower extremity, below knee, flexible inner socket, external frame","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75825","name":"Vein x-ray trunk","description":"Venography, caval, inferior, with serialography, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90470","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29827","name":"Sho arthrs srg rt8tr cuf rpr","description":"Arthroscopy, shoulder, surgical; with rotator cuff repair","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3960","name":"Sewho airplan desig abdu pos","description":"Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0491","name":"Oral dv nm mouthpc hw remote","description":"Oral device/appliance for neuromuscular electrical stimulation of the tongue muscle, used in conjunction with the power source and control electronics unit, controlled by hardware remote, 90-day supply","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"75716","name":"Artery x-rays arms/legs","description":"Angiography, extremity, bilateral, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53000","name":"Incision of urethra","description":"Urethrotomy or urethrostomy, external (separate procedure); pendulous urethra","date_of_service":"2026-05-10","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":"57800","name":"Dilation of cervical canal","description":"Dilation of cervical canal, instrumental (separate procedure)","date_of_service":"2026-05-10","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":"63620","name":"Srs spinal lesion","description":"Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 spinal lesion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0160","name":"Sitz type bath or equipment","description":"Sitz type bath or equipment, portable, used with or without commode","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1057.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92285","name":"External ocular photography","description":"External ocular photography with interpretation and report for documentation of medical progress (eg, close-up photography, slit lamp photography, goniophotography, stereo-photography)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86485","name":"Skin test candida","description":"Skin test; candida","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"44820","name":"Excision of mesentery lesion","description":"Excision of lesion of mesentery (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":690.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8480","name":"Pros sock single ply ak","description":"Prosthetic sock, single ply, fitting, above knee, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50021","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":786.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5510","name":"Prep bk ptb plaster molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model","date_of_service":"2026-05-10","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":"65710","name":"Corneal transplant","description":"Keratoplasty (corneal transplant); anterior lamellar","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":676.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2380","name":"Torsion straight knee joint","description":"Addition to lower extremity, torsion control, straight knee joint, each joint","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["23","21","49","02","65","81","32","11","24","22","33","10","13","12","31"],"billing_code_modifier":["GT","GQ","95","93","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65860","name":"Severing ads ant sgm laser","description":"Severing adhesions of anterior segment, laser technique (separate procedure)","date_of_service":"2026-05-10","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":"73060","name":"X-ray exam of humerus","description":"Radiologic examination; humerus, minimum of 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82760","name":"Assay of galactose","description":"Galactose","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1949.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0900","name":"Trac stand free stand pelvic","description":"Traction stand, free standing, pelvic traction, (e.g., bucks)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1034","name":"Wheelchair trunk hip support","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for lateral trunk or hip support, any type","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2510","name":"Cntct gas permeable sphericl","description":"Contact lens, gas permeable, spherical, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","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":"30560","name":"Lysis intranasal synechia","description":"Lysis intranasal synechia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2728.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-10","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":"67038","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1665.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"A7028","name":"Repl oral cushion combo mask","description":"Oral cushion for combination oral/nasal mask, replacement only, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KN"]}],"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":"2026-05-10","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":"87910","name":"Nfct agt gntyp alys cmv","description":"Infectious agent genotype analysis by nucleic acid (dna or rna); cytomegalovirus","date_of_service":"2026-05-10","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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":729.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98941","name":"Chiropract manj 3-4 regions","description":"Chiropractic manipulative treatment (cmt); spinal, 3-4 regions","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75842","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42809","name":"Remove pharynx foreign body","description":"Removal of foreign body from pharynx","date_of_service":"2026-05-10","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":"47381","name":"Open ablate liver tumor cryo","description":"Ablation, open, of 1 or more liver tumor(s); cryosurgical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1583.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"78710","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67250","name":"Reinforce eye wall","description":"Scleral reinforcement (separate procedure); without graft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":819.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2314","name":"Lens sphcyl trifocal over 12","description":"Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","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":"29540","name":"Strapping ankle &/foot","description":"Strapping; ankle and/or foot","date_of_service":"2026-05-10","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":"19301","name":"Partial mastectomy","description":"Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy);","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76390","name":"Mr spectroscopy","description":"Magnetic resonance spectroscopy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1238.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"90662","name":"Iiv no prsv increased ag im","description":"Influenza virus vaccine (iiv), split virus, preservative free, enhanced immunogenicity via increased antigen content, for intramuscular use","date_of_service":"2026-05-10","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":98.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0366","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"15840","name":"Nerve palsy fascial graft","description":"Graft for facial nerve paralysis; free fascia graft (including obtaining fascia)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3056.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"95907","name":"Nvr cndj tst 1-2 studies","description":"Nerve conduction studies; 1-2 studies","date_of_service":"2026-05-10","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":"23530","name":"Optx strnclav dislc aqt/chrn","description":"Open treatment of sternoclavicular dislocation, acute or chronic;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-10","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":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6935","name":"Below elbow myoelectronic ct","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"78191","name":"Platelet survival study","description":"Platelet survival study","date_of_service":"2026-05-10","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":"58974","name":"Embryo transfer intrauterine","description":"Embryo transfer, intrauterine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A9505","name":"Tl201 thallium","description":"Thallium tl-201 thallous chloride, diagnostic, per millicurie","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"74177","name":"Ct abd & pelvis w/contrast","description":"Computed tomography, abdomen and pelvis; with contrast material(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35226","name":"Repair blood vessel dir lxtr","description":"Repair blood vessel, direct; lower extremity","date_of_service":"2026-05-10","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":"24343","name":"Repr elbow lat ligmnt w/tiss","description":"Repair lateral collateral ligament, elbow, with local tissue","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85049","name":"Automated platelet count","description":"Blood count; platelet, automated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01490","name":"Anes lwr leg cst app rmv/rpr","description":"Anesthesia for lower leg cast application, removal, or repair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"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":"2026-05-10","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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86652","name":"Encephaltis east eqne anbdy","description":"Antibody; encephalitis, eastern equine","date_of_service":"2026-05-10","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":"66625","name":"Removal of iris","description":"Iridectomy, with corneoscleral or corneal section; peripheral for glaucoma (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2627","name":"Scleral cover shell","description":"Scleral cover shell","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"24138","name":"Sequestrectomy olecrn proces","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), olecranon process","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4381","name":"Urinary plastic pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, plastic, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47370","name":"Laparo ablate liver tumor rf","description":"Laparoscopy, surgical, ablation of 1 or more liver tumor(s); radiofrequency","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-10","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":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1972.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2069.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E0302","name":"Ex hd hosp bed > 600 lbs","description":"Hospital bed, extra heavy duty, extra wide, with weight capacity greater than 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3645.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":658.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"95929","name":"C motor evoked lwr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); lower limbs","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","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":"J0880","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"J2765","name":"Metoclopramide hcl injection","description":"Injection, metoclopramide hcl, up to 10 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":910.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76094","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1326.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L0488","name":"Tlso rigid lined pre one pie","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68801","name":"Dilate tear duct opening","description":"Dilation of lacrimal punctum, with or without irrigation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1297","name":"Wheelchair special seat dept","description":"Special wheelchair seat depth, by upholstery","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":891.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"S8100","name":"Spacer without mask","description":"Holding chamber or spacer for use with an inhaler or nebulizer; without mask","date_of_service":"2026-05-10","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":"83625","name":"Assay of ldh enzymes","description":"Lactate dehydrogenase (ld), (ldh); isoenzymes, separation and quantitation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"55725","name":"Drainage of prostate abscess","description":"Prostatotomy, external drainage of prostatic abscess, any approach; complicated","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5726","name":"Knee-shin ext jnts fld swg e","description":"Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1590.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46320","name":"Removal of hemorrhoid clot","description":"Excision of thrombosed hemorrhoid, external","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6407","name":"Packing strips, non-impreg","description":"Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77063","name":"Breast tomosynthesis bi","description":"Screening digital breast tomosynthesis, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1390.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q4055","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43312","name":"Repair esophagus and fistula","description":"Esophagoplasty (plastic repair or reconstruction), thoracic approach; with repair of tracheoesophageal fistula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00630","name":"Anes px lumbar region nos","description":"Anesthesia for procedures in lumbar region; not otherwise specified","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5010","name":"Mold socket ank hgt w/ toe f","description":"Partial foot, molded socket, ankle height, with toe filler","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"43886","name":"Gstr rstcv px opn revj port","description":"Gastric restrictive procedure, open; revision of subcutaneous port component only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71110","name":"X-ray exam ribs bil 3 views","description":"Radiologic examination, ribs, bilateral; 3 views","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"J8700","name":"Temozolomide","description":"Temozolomide, oral, 5 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1209.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":761.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82550","name":"Assay of ck (cpk)","description":"Creatine kinase (ck), (cpk); total","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0601","name":"Repl batt silver oxide 1.5 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","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":"95824","name":"Eeg cerebral death only","description":"Electroencephalogram (eeg); cerebral death evaluation only","date_of_service":"2026-05-10","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":"23505","name":"Cltx clavicular fx w/mnpj","description":"Closed treatment of clavicular fracture; with manipulation","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95865","name":"Needle emg larynx","description":"Needle electromyography; larynx","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33460","name":"Revision of tricuspid valve","description":"Valvectomy, tricuspid valve, with cardiopulmonary bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71022","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73620","name":"X-ray exam of foot","description":"Radiologic examination, foot; 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26565","name":"Correct metacarpal flaw","description":"Osteotomy; metacarpal, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":913.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2783.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["26"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0618","name":"Apnea monitor","description":"Apnea monitor, without recording feature","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":884.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6692","name":"Silicon gel insert w/wo lock","description":"Upper extremity addition, silicone gel insert or equal, with or without locking mechanism, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50660","name":"Removal of ureter","description":"Ureterectomy, total, ectopic ureter, combination abdominal, vaginal and/or perineal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1262.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1019.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49081","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35231","name":"Repair blvsl vn grf neck","description":"Repair blood vessel with vein graft; neck","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1458.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"36861","name":"Cannula declotting","description":"External cannula declotting (separate procedure); with balloon catheter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2112","name":"Spherocylindr 7.25d/2.25-4d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25d to 4.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5685","name":"Below knee sus/seal sleeve","description":"Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":544.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61490","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"59830","name":"Treat uterus infection","description":"Treatment of septic abortion, completed surgically","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73030","name":"X-ray exam of shoulder","description":"Radiologic examination, shoulder; complete, minimum of 2 views","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4550","name":"Surgical trays","description":"Surgical trays","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0467","name":"Tlso r fram soft pre ots","description":"Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47785","name":"Fuse bile ducts and bowel","description":"Anastomosis, roux-en-y, of intrahepatic biliary ducts and gastrointestinal tract","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69718","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1691.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76998","name":"Us guide intraop","description":"Ultrasonic guidance, intraoperative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"0150T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"76390","name":"Mr spectroscopy","description":"Magnetic resonance spectroscopy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3380","name":"Shoe clubfoot wedge","description":"Clubfoot wedge","date_of_service":"2026-05-10","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":"34520","name":"Cross-over vein graft","description":"Cross-over vein graft to venous system","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1272.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":825.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1296.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94400","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7012","name":"Nebulizer water collec devic","description":"Water collection device, used with large volume nebulizer","date_of_service":"2026-05-10","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":"23395","name":"Muscle transfer shoulder/arm","description":"Muscle transfer, any type, shoulder or upper arm; single","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6024","name":"Collagen dsg wound filler","description":"Collagen dressing wound filler, sterile, per 6 inches","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"58700","name":"Removal of fallopian tube","description":"Salpingectomy, complete or partial, unilateral or bilateral (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72131","name":"Ct lumbar spine w/o dye","description":"Computed tomography, lumbar spine; without contrast material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91304","name":"Sarscov2 vac 5mcg/0.5ml im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, 5 mcg/0.5 ml dosage, for intramuscular use","date_of_service":"2026-05-10","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":191.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0504T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"86713","name":"Legionella antibody","description":"Antibody; legionella","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4372","name":"Skin barrier solid 4x4 equiv","description":"Ostomy skin barrier, solid 4 x 4 or equivalent, standard wear, with built-in convexity, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KL","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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38380","name":"Thoracic duct procedure","description":"Suture and/or ligation of thoracic duct; cervical approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1814","name":"Adjust knee flexion device","description":"Dynamic adjustable knee flexion only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1885.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":768.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86064","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":243.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-05-10","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":"76066","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88161","name":"Cytopath smear other source","description":"Cytopathology, smears, any other source; preparation, screening and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78001","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6450","name":"Elb disart prosth tiss shap","description":"Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"57250","name":"Repair rectum & vagina","description":"Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":673.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2219","name":"Foam caster tire any size ea","description":"Manual wheelchair accessory, foam caster tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":"25300","name":"Fusion of tendons at wrist","description":"Tenodesis at wrist; flexors of fingers","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":571.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75660","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0444","name":"Portable 02 contents, liquid","description":"Portable oxygen contents, liquid, 1 months supply = 1 unit","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"93581","name":"Transcath closure of vsd","description":"Percutaneous transcatheter closure of a congenital ventricular septal defect with implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"86793","name":"Yersinia antibody","description":"Antibody; yersinia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33877","name":"Thoracoabdominal graft","description":"Repair of thoracoabdominal aortic aneurysm with graft, with or without cardiopulmonary bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2881.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"26991","name":"Drainage of pelvis bursa","description":"Incision and drainage, pelvis or hip joint area; infected bursa","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"90823","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1858.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5855","name":"Mech hip extension assist","description":"Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"19110","name":"Nipple exploration","description":"Nipple exploration, with or without excision of a solitary lactiferous duct or a papilloma lactiferous duct","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"27602","name":"Decompression of lower leg","description":"Decompression fasciotomy, leg; anterior and/or lateral, and posterior compartment(s)","date_of_service":"2026-05-10","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":"34510","name":"Transposition of vein valve","description":"Venous valve transposition, any vein donor","date_of_service":"2026-05-10","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":"00770","name":"Anes px maj abd blood vessel","description":"Anesthesia for all procedures on major abdominal blood vessels","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.16,"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":"76977","name":"Us bone density measure","description":"Ultrasound bone density measurement and interpretation, peripheral site(s), any method","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"48152","name":"Pancreatectomy","description":"Pancreatectomy, proximal subtotal with total duodenectomy, partial gastrectomy, choledochoenterostomy and gastrojejunostomy (whipple-type procedure); without pancreatojejunostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3017.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L5696","name":"Ak/knee disartic pelvic join","description":"Addition to lower extremity, above knee or knee disarticulation, pelvic joint","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37224","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1722.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4312","name":"Cath w/o bag 2-way silicone","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way, all silicone","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84479","name":"Assay of thyroid (t3 or t4)","description":"Thyroid hormone (t3 or t4) uptake or thyroid hormone binding ratio (thbr)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J2910","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71030","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44950","name":"Appendectomy","description":"Appendectomy;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":696.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83892","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP16","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6212","name":"Foam drg <=16 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29046","name":"Appl bdy cst sho to hip b th","description":"Application of body cast, shoulder to hips; including both thighs","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L3400","name":"Shoe metatarsal bar wedge ro","description":"Metatarsal bar wedge, rocker","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50398","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"64642","name":"Chemodenerv 1 extremity 1-4","description":"Chemodenervation of one extremity; 1-4 muscle(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2500.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"57530","name":"Removal of cervix","description":"Trachelectomy (cervicectomy), amputation of cervix (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":313.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41105","name":"Biopsy of tongue","description":"Biopsy of tongue; posterior one-third","date_of_service":"2026-05-10","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":"63286","name":"Bx/exc idrl imed lesn thrc","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, thoracic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2983.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50020","name":"Drg perirnl/renal absc open","description":"Drainage of perirenal or renal abscess, open","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85014","name":"Hematocrit","description":"Blood count; hematocrit (hct)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"51701","name":"Insert bladder catheter","description":"Insertion of non-indwelling bladder catheter (eg, straight catheterization for residual urine)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88184","name":"Flowcytometry/ tc 1 marker","description":"Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical component only; first marker","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8410","name":"Sheath above knee","description":"Prosthetic sheath, above knee, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":559.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21450","name":"Cltx mndblr fx w/o mnpj","description":"Closed treatment of mandibular fracture; without manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":469.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"J0600","name":"Edetate calcium disodium inj","description":"Injection, edetate calcium disodium, up to 1000 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2356.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0416","name":"Prostate biopsy, any mthd","description":"Surgical pathology, gross and microscopic examinations, for prostate needle biopsy, any method","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67975","name":"Reconstruction of eyelid","description":"Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; second stage","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":733.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"Q4030","name":"Cast sup long leg fiberglass","description":"Cast supplies, long leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"88130","name":"Sex chromatin identification","description":"Sex chromatin identification; barr bodies","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77789","name":"Apply surf ldr radionuclide","description":"Surface application of low dose rate radionuclide source","date_of_service":"2026-05-10","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":"A5500","name":"Diab shoe for density insert","description":"For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33404","name":"Prepare heart-aorta conduit","description":"Construction of apical-aortic conduit","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2132.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50100","name":"Trnsxj/repos abrrnt rnl vsls","description":"Transection or repositioning of aberrant renal vessels (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1155.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0683","name":"Non pneu peristalic comp pmp","description":"Non-pneumatic, non-sequential, peristaltic wave compression pump","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59020","name":"Fetal contract stress test","description":"Fetal contraction stress test","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"74300","name":"X-ray bile ducts/pancreas","description":"Cholangiography and/or pancreatography; intraoperative, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"E1008","name":"Pwr seat combo pwr shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with power shear reduction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"73580","name":"Contrast x-ray of knee joint","description":"Radiologic examination, knee, arthrography, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","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":"73050","name":"X-ray exam of shoulders","description":"Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"27286","name":"Arthrd hip jt sbtrchc osteot","description":"Arthrodesis, hip joint (including obtaining graft); with subtrochanteric osteotomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":323.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27656","name":"Repair leg fascia defect","description":"Repair, fascial defect of leg","date_of_service":"2026-05-10","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":"38204","name":"Bl donor search management","description":"Management of recipient hematopoietic progenitor cell donor search and cell acquisition","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E0181","name":"Press pad alternating w/ pum","description":"Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63272","name":"Excise intrspinl lesion lmbr","description":"Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; lumbar","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1704.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0986","name":"Man w/c powr assist syst","description":"Manual wheelchair accessory, power assist system","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4267","name":"Male condom","description":"Contraceptive supply, condom, male, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"0247T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"50070","name":"Nl comp cgen kdn abnormality","description":"Nephrolithotomy; complicated by congenital kidney abnormality","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92620","name":"Auditory function 60 min","description":"Evaluation of central auditory function, with report; initial 60 minutes","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":571.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5370.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78110","name":"Plasma volume single","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling","date_of_service":"2026-05-10","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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"G6003","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5460","name":"Postop app non-wgt bear dsg","description":"Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53440","name":"Male sling procedure","description":"Sling operation for correction of male urinary incontinence (eg, fascia or synthetic)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":806.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"46230","name":"Removal of anal tags","description":"Excision of multiple external papillae or tags, anus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-05-10","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":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6628","name":"Quick disconn hook adapter o","description":"Upper extremity addition, quick disconnect hook adapter, otto bock or equal","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2368","name":"Pwr wc drivewheel motor repl","description":"Power wheelchair component, drive wheel motor, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1232.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6441","name":"Pad band w>=3in <5in/yd","description":"Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87077","name":"Culture aerobic identify","description":"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"76098","name":"X-ray exam surgical specimen","description":"Radiological examination, surgical specimen","date_of_service":"2026-05-10","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":"23182","name":"Prtl excision bone scapula","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), scapula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":825.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"30300","name":"Remove nasal foreign body","description":"Removal foreign body, intranasal; office type procedure","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":789.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"49321","name":"Laparoscopy biopsy","description":"Laparoscopy, surgical; with biopsy (single or multiple)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"76098","name":"X-ray exam surgical specimen","description":"Radiological examination, surgical specimen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"C1769","name":"Guide wire","description":"Guide wire","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J0745","name":"Inj codeine phosphate /30 mg","description":"Injection, codeine phosphate, per 30 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E1298","name":"Wheelchair spec seat depth/w","description":"Special wheelchair seat depth and/or width, by construction","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":952.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6209","name":"Foam drsg <=16 sq in w/o bdr","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-10","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":"93232","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0863","name":"Pwc gp3 vhd mult pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E0575","name":"Nebulizer ultrasonic","description":"Nebulizer, ultrasonic, large volume","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"75896","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"43825","name":"Gastrojejunostomy w/vagotomy","description":"Gastrojejunostomy; with vagotomy, any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1325.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6646","name":"Multipo locking shoulder jnt","description":"Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"77790","name":"Radiation handling","description":"Supervision, handling, loading of radiation source","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4048","name":"Cast sup sht leg splnt ped f","description":"Cast supplies, short leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E0316","name":"Bed safety enclosure","description":"Safety enclosure frame/canopy for use with hospital bed, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91022","name":"Duodenal motility study","description":"Duodenal motility (manometric) study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5082","name":"Continent stoma catheter","description":"Continent device; catheter for continent stoma","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43886","name":"Gstr rstcv px opn revj port","description":"Gastric restrictive procedure, open; revision of subcutaneous port component only","date_of_service":"2026-05-10","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":"75891","name":"Vein x-ray liver","description":"Hepatic venography, wedged or free, without hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45340","name":"Sig w/tndsc balloon dilation","description":"Sigmoidoscopy, flexible; with transendoscopic balloon dilation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70328","name":"X-ray exam of jaw joint","description":"Radiologic examination, temporomandibular joint, open and closed mouth; unilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":499.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"77620","name":"Hyperthermia gen intrcv prb","description":"Hyperthermia generated by intracavitary probe(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"0147T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0236","name":"Pump for water circulating p","description":"Pump for water circulating pad","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84490","name":"Assay of feces for trypsin","description":"Trypsin; feces, quantitative, 24-hour collection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0935","name":"Cont pas motion exercise dev","description":"Continuous passive motion exercise device for use on knee only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"33241","name":"Remove pulse generator","description":"Removal of implantable defibrillator pulse generator only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2311","name":"Lens sphc trifo 7.25-12/.25-","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-10","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":"21453","name":"Cltx mndblr fx ntrdntl fixj","description":"Closed treatment of mandibular fracture with interdental fixation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":694.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96921","name":"Excimer lsr psriasis 250-500","description":"Excimer laser treatment for psoriasis; 250 sq cm to 500 sq cm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76872","name":"Us transrectal","description":"Ultrasound, transrectal;","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5505","name":"Init ak ischal plstr direct","description":"Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1523.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"85044","name":"Manual reticulocyte count","description":"Blood count; reticulocyte, manual","date_of_service":"2026-05-10","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":"53444","name":"Insert tandem cuff","description":"Insertion of tandem cuff (dual cuff)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":642.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01654","name":"Anes art sho&ax bypass grf","description":"Anesthesia for procedures on arteries of shoulder and axilla; bypass graft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","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":"E0984","name":"Add pwr tiller","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93562","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":726.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"18583","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"20612","name":"Aspirate/inj ganglion cyst","description":"Aspiration and/or injection of ganglion cyst(s) any location","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27712","name":"Osteot mlt relignmt imed rod","description":"Osteotomy; multiple, with realignment on intramedullary rod (eg, sofield type procedure)","date_of_service":"2026-05-10","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":"44156","name":"Removal of colon/ileostomy","description":"Colectomy, total, abdominal, with proctectomy; with continent ileostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1935.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7041","name":"Water seal drain container","description":"Water seal drainage container and tubing for use with implanted chest tube","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":889.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86593","name":"Syphilis test non-trep quant","description":"Syphilis test, non-treponemal antibody; quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":543.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76512","name":"Oph us dx b-scan","description":"Ophthalmic ultrasound, diagnostic; b-scan (with or without superimposed non-quantitative a-scan)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"61566","name":"Removal of brain tissue","description":"Craniotomy with elevation of bone flap; for selective amygdalohippocampectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75600","name":"Contrast exam thoracic aorta","description":"Aortography, thoracic, without serialography, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"35907","name":"Excision graft abdomen","description":"Excision of infected graft; abdomen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2410.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4315","name":"Cath w/drainage 2-way silcne","description":"Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1050.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32940","name":"Revision of lung","description":"Pneumonolysis, extraperiosteal, including filling or packing procedures","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67938","name":"Remove eyelid foreign body","description":"Removal of embedded foreign body, eyelid","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01462","name":"Anes clsd px lower l/a/f","description":"Anesthesia for all closed procedures on lower leg, ankle, and foot","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8630","name":"Metacarpophalangeal implant","description":"Metacarpophalangeal joint implant","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76873","name":"Echograp trans r pros study","description":"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure)","date_of_service":"2026-05-10","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":"44186","name":"Lap jejunostomy","description":"Laparoscopy, surgical; jejunostomy (eg, for decompression or feeding)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","date_of_service":"2026-05-10","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":"29705","name":"Rmvl/bivlv full arm/leg cast","description":"Removal or bivalving; full arm or full leg cast","date_of_service":"2026-05-10","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":"27596","name":"Amputation follow-up surgery","description":"Amputation, thigh, through femur, any level; re-amputation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1025","name":"Kyphosis pad floating","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad, floating","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"46606","name":"Anoscopy and biopsy","description":"Anoscopy; with biopsy, single or multiple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3967","name":"Sewho airplane w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":"93541","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q2002","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1456.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7505","name":"Hmes or trach valve housing","description":"Housing, reusable without adhesive, for use in a heat and moisture exchange system and/or with a tracheostoma valve, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"86664","name":"Epstein-barr nuclear antigen","description":"Antibody; epstein-barr (eb) virus, nuclear antigen (ebna)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"70210","name":"X-ray exam of sinuses","description":"Radiologic examination, sinuses, paranasal, less than 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":42.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21315","name":"Clsd tx nsl fx mnpj wo stblj","description":"Closed treatment of nasal bone fracture with manipulation; without stabilization","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00470","name":"Anes partial rib rescj nos","description":"Anesthesia for partial rib resection; not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"33496","name":"Repair prosth valve clot","description":"Repair of non-structural prosthetic valve dysfunction with cardiopulmonary bypass (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29894","name":"Ankle arthroscopy/surgery","description":"Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; with removal of loose body or foreign body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":628.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"74010","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"85530","name":"Heparin-protamine tolerance","description":"Heparin-protamine tolerance test","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67909","name":"Revise eyelid defect","description":"Reduction of overcorrection of ptosis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00846","name":"Anes iper px rad hystrectomy","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; radical hysterectomy","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":205.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J0152","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27496","name":"Decompression of thigh/knee","description":"Decompression fasciotomy, thigh and/or knee, 1 compartment (flexor or extensor or adductor);","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":579.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75880","name":"Vein x-ray eye socket","description":"Venography, orbital, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"82690","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"20974","name":"Estim aid bone healg n-invas","description":"Electrical stimulation to aid bone healing; noninvasive (nonoperative)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":57.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88174","name":"Cytopath c/v auto in fluid","description":"Cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation; screening by automated system, under physician supervision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"95900","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86906","name":"Bld typing serologic rh phnt","description":"Blood typing, serologic; rh phenotyping, complete","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"J1327","name":"Eptifibatide injection","description":"Injection, eptifibatide, 5 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90376","name":"Rabies ig heat treated","description":"Rabies immune globulin, heat-treated (rig-ht), human, for intramuscular and/or subcutaneous use","date_of_service":"2026-05-10","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":66.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7034","name":"Nasal application device","description":"Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71111","name":"X-ray exam ribs/chest4/> vws","description":"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5685","name":"Below knee sus/seal sleeve","description":"Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"74300","name":"X-ray bile ducts/pancreas","description":"Cholangiography and/or pancreatography; intraoperative, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7017","name":"Nebulizer not used w oxygen","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47300","name":"Surgery for liver lesion","description":"Marsupialization of cyst or abscess of liver","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":940.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97016","name":"Vasopneumatic device therapy","description":"Application of a modality to 1 or more areas; vasopneumatic devices","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95863","name":"Needle emg 3 extremities","description":"Needle electromyography; 3 extremities with or without related paraspinal areas","date_of_service":"2026-05-10","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":"93000","name":"Electrocardiogram complete","description":"Electrocardiogram, routine ecg with at least 12 leads; with interpretation and report","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"E0930","name":"Fracture frame free standing","description":"Fracture frame, free standing, includes weights","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"J2675","name":"Inj progesterone per 50 mg","description":"Injection, progesterone, per 50 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"26340","name":"Manipulate finger w/anesth","description":"Manipulation, finger joint, under anesthesia, each joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":360.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"22224","name":"Osteot dsc ant 1vrt sgm lmbr","description":"Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; lumbar","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4750","name":"Art or venous blood tubing","description":"Blood tubing, arterial or venous, for hemodialysis, each","date_of_service":"2026-05-10","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":"69150","name":"Extensive ear canal surgery","description":"Radical excision external auditory canal lesion; without neck dissection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1266.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4039","name":"Cast sup shrt leg ped plster","description":"Cast supplies, short leg cast, pediatric (0-10 years), plaster","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":918.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"68760","name":"Close tear duct opening","description":"Closure of the lacrimal punctum; by thermocauterization, ligation, or laser surgery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1040.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2620","name":"Pelvic control hip heavy dut","description":"Addition to lower extremity, pelvic control, hip joint, heavy duty, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70332","name":"X-ray exam of jaw joint","description":"Temporomandibular joint arthrography, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1150","name":"Wheelchair standard w/ leg r","description":"Wheelchair, detachable arms, desk or full length swing away detachable elevating legrests","date_of_service":"2026-05-10","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":"27151","name":"Incision of hip bones","description":"Osteotomy, iliac, acetabular or innominate bone; with femoral osteotomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1346.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30160","name":"Rhinectomy total","description":"Rhinectomy; total","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47720","name":"Fuse gallbladder & bowel","description":"Cholecystoenterostomy; direct","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33213","name":"Insert pulse gen dual leads","description":"Insertion of pacemaker pulse generator only; with existing dual leads","date_of_service":"2026-05-10","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":"32552","name":"Remove lung catheter","description":"Removal of indwelling tunneled pleural catheter with cuff","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36593","name":"Declot vascular device","description":"Declotting by thrombolytic agent of implanted vascular access device or catheter","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V5266","name":"Battery for hearing device","description":"Battery for use in hearing device","date_of_service":"2026-05-10","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":"83892","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"38571","name":"Laparoscopy lymphadenectomy","description":"Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0637","name":"Lso sc r ant/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes ","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28060","name":"Partial removal foot fascia","description":"Fasciectomy, plantar fascia; partial (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"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":"2026-05-10","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":"97012","name":"Mechanical traction therapy","description":"Application of a modality to 1 or more areas; traction, mechanical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-10","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":"27345","name":"Removal of knee cyst","description":"Excision of synovial cyst of popliteal space (eg, bakers cyst)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":406.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70140","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; less than 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4341","name":"Iduc valve pat inst repl","description":"Indwelling intraurethral drainage device with valve, patient inserted, replacement only, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":522.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5210","name":"No knee/ankle joints w/ ft b","description":"Above knee, short prosthesis, no knee joint (stubbies), with foot blocks, no ankle joints, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78195","name":"Lymph system imaging","description":"Lymphatics and lymph nodes imaging","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1900","name":"Afo sprng wir drsflx calf bd","description":"Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28820","name":"Amputation of toe","description":"Amputation, toe; metatarsophalangeal joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":399.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":735.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4459","name":"Transanal irrigation, any","description":"Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-10","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":"93618","name":"Indctj arrhythmia elec pacg","description":"Induction of arrhythmia by electrical pacing","date_of_service":"2026-05-10","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":"42500","name":"Repair salivary duct","description":"Plastic repair of salivary duct, sialodochoplasty; primary or simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87168","name":"Macroscopic exam arthropod","description":"Macroscopic examination; arthropod","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64857","name":"Repair arm/leg nerve","description":"Suture of major peripheral nerve, arm or leg, except sciatic; without transposition","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":884.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"Q4023","name":"Cast sup sht arm splnt ped p","description":"Cast supplies, short arm splint, pediatric (0-10 years), plaster","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","date_of_service":"2026-05-10","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":"46735","name":"Construction of absent anus","description":"Repair of high imperforate anus without fistula; combined transabdominal and sacroperineal approaches","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2155.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"61702","name":"Inner skull vessel surgery","description":"Surgery of simple intracranial aneurysm, intracranial approach; vertebrobasilar circulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3888.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62115","name":"Reduction of skull defect","description":"Reduction of craniomegalic skull (eg, treated hydrocephalus); not requiring bone grafts or cranioplasty","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33889","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62165","name":"Remove pituit tumor w/scope","description":"Neuroendoscopy, intracranial; with excision of pituitary tumor, transnasal or trans-sphenoidal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1724.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"11721","name":"Debride nail 6 or more","description":"Debridement of nail(s) by any method(s); 6 or more","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1568.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-10","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":"83055","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"24361","name":"Reconstruct elbow joint","description":"Arthroplasty, elbow; with distal humeral prosthetic replacement","date_of_service":"2026-05-10","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":"L8417","name":"Pros sheath/sock w gel cushn","description":"Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each","date_of_service":"2026-05-10","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":"91132","name":"Electrogastrography","description":"Electrogastrography, diagnostic, transcutaneous;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86304","name":"Immunoassay tumor ca 125","description":"Immunoassay for tumor antigen, quantitative; ca 125","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1334.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3007.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"31255","name":"Nsl/sins ndsc w/tot ethmdct","description":"Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":525.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00563","name":"Anes px heart w/pmp crc arst","description":"Anesthesia for procedures on heart, pericardial sac, and great vessels of chest; with pump oxygenator with hypothermic circulatory arrest","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":566.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87290","name":"Varicella zoster ag if","description":"Infectious agent antigen detection by immunofluorescent technique; varicella zoster virus","date_of_service":"2026-05-10","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":"65135","name":"Insert ocular implant","description":"Insertion of ocular implant secondary; after enucleation, muscles not attached to implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":483.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51705","name":"Change of bladder tube","description":"Change of cystostomy tube; simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85525","name":"Heparin neutralization","description":"Heparin neutralization","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":544.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21336","name":"Open tx septal fx w/wo stabj","description":"Open treatment of nasal septal fracture, with or without stabilization","date_of_service":"2026-05-10","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":"L5520","name":"Perp bk ptb thermopls direct","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7014","name":"Compressor nondispos filter","description":"Filter, nondisposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L6686","name":"Suction socket","description":"Upper extremity addition, suction socket","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":720.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1426.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0456","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67413","name":"Explore/treat eye socket","description":"Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of foreign body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":954.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"11971","name":"Rmvl tis xpndr wo insj implt","description":"Removal of tissue expander without insertion of implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":206.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40843","name":"Reconstruction of mouth","description":"Vestibuloplasty; posterior, bilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":940.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71010","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"54111","name":"Treat penis lesion graft","description":"Excision of penile plaque (peyronie disease); with graft to 5 cm in length","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"58974","name":"Embryo transfer intrauterine","description":"Embryo transfer, intrauterine","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4422","name":"Ost pouch absorbent material","description":"Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0660","name":"Pneumatic appliance full leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"L2750","name":"Plating chrome/nickel pr bar","description":"Addition to lower extremity orthosis, plating chrome or nickel, per bar","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0247","name":"Trans bench w/wo comm open","description":"Transfer bench for tub or toilet with or without commode opening","date_of_service":"2026-05-10","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":"G9041","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1290","name":"Lateral trochanteric pad","description":"Addition to tlso, (low profile), lateral trochanteric pad","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"87168","name":"Macroscopic exam arthropod","description":"Macroscopic examination; arthropod","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"67810","name":"Incal bx eyelid skn lid mrgn","description":"Incisional biopsy of eyelid skin including lid margin","date_of_service":"2026-05-10","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":"68850","name":"Injection for tear sac x-ray","description":"Injection of contrast medium for dacryocystography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84295","name":"Assay of serum sodium","description":"Sodium; serum, plasma or whole blood","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31510","name":"Laryngoscopy with biopsy","description":"Laryngoscopy, indirect; with biopsy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11770","name":"Exc pilonidal cyst simple","description":"Excision of pilonidal cyst or sinus; simple","date_of_service":"2026-05-10","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":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"82565","name":"Assay of creatinine","description":"Creatinine; blood","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51535","name":"Repair of ureter lesion","description":"Cystotomy for excision, incision, or repair of ureterocele","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":878.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4207","name":"2 cc sterile syringe&needle","description":"Syringe with needle, sterile 2 cc, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"26494","name":"Hand tendon/muscle transfer","description":"Opponensplasty; hypothenar muscle transfer","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1048.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94726","name":"Plethysmography lung volumes","description":"Plethysmography for determination of lung volumes and, when performed, airway resistance","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"54015","name":"I&d penis deep","description":"Incision and drainage of penis, deep","date_of_service":"2026-05-10","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":"01220","name":"Anes clsd px upper 2/3 femur","description":"Anesthesia for all closed procedures involving upper two-thirds of femur","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","date_of_service":"2026-05-10","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":"E1228","name":"Wheelchair spec sz spec ht b","description":"Special back height for wheelchair","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1060","name":"Wheelchair detachable arms","description":"Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"67346","name":"Biopsy eye muscle","description":"Biopsy of extraocular muscle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","date_of_service":"2026-05-10","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":"79101","name":"Nuclear rx iv admin","description":"Radiopharmaceutical therapy, by intravenous administration","date_of_service":"2026-05-10","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":"0441T","name":"Abltj perc lxtr/perph nrv","description":"Ablation, percutaneous, cryoablation, includes imaging guidance; lower extremity distal/peripheral nerve","date_of_service":"2026-05-10","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":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":418.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5975","name":"Combo ankle/foot prosthesis","description":"All lower extremity prosthesis, combination single axis ankle and flexible keel foot","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8609","name":"Artificial cornea","description":"Artificial cornea","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"82000","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0650","name":"Pneuma compresor non-segment","description":"Pneumatic compressor, non-segmental home model","date_of_service":"2026-05-10","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":"G0417","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92565","name":"Stenger test pure tone","description":"Stenger test, pure tone","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5643","name":"Hip flex inner socket ext fr","description":"Addition to lower extremity, hip disarticulation, flexible inner socket, external frame","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":772.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15738","name":"Muscle-skin graft leg","description":"Muscle, myocutaneous, or fasciocutaneous flap; lower extremity","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1457.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":639.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":518.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1205.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["MS"]}],"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":"2026-05-10","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":"85652","name":"Rbc sed rate automated","description":"Sedimentation rate, erythrocyte; automated","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"A6242","name":"Hydrogel drg <=16 in w/o bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"L7367","name":"Replacemnt lithium ionbatter","description":"Lithium ion battery, rechargeable, replacement","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6453","name":"Self-adher band w <3in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":860.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"42227","name":"Lengthening of palate","description":"Lengthening of palate, with island flap","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1193.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97002","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4355","name":"Bladder irrigation tubing","description":"Irrigation tubing set for continuous bladder irrigation through a three-way indwelling foley catheter, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6360","name":"Thoracic passive restor comp","description":"Interscapular thoracic, passive restoration (complete prosthesis)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"54660","name":"Revision of testis","description":"Insertion of testicular prosthesis (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85360","name":"Euglobulin lysis","description":"Euglobulin lysis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"L2760","name":"Extension per extension per","description":"Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)","date_of_service":"2026-05-10","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":"L6655","name":"Standard control cable extra","description":"Upper extremity addition, standard control cable, extra","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L4050","name":"Replace molded calf lacer","description":"Replace molded calf lacer, for custom fabricated orthosis only","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"36822","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8001","name":"Breast prosthesis bra & form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type","date_of_service":"2026-05-10","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":"J2950","name":"Promazine hcl injection","description":"Injection, promazine hcl, up to 25 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"78071","name":"Parathyrd planar w/wo subtrj","description":"Parathyroid planar imaging (including subtraction, when performed); with tomographic (spect)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88342","name":"Imhchem/imcytchm 1st antb","description":"Immunohistochemistry or immunocytochemistry, per specimen; initial single antibody stain procedure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51860","name":"Repair of bladder wound","description":"Cystorrhaphy, suture of bladder wound, injury or rupture; simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":616.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0948","name":"Fracture frame attachmnts ce","description":"Fracture frame, attachments for complex cervical traction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"96422","name":"Chemo ia infusion up to 1 hr","description":"Chemotherapy administration, intra-arterial; infusion technique, up to 1 hour","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01842","name":"Anes art farm wrst&hnd emblc","description":"Anesthesia for procedures on arteries of forearm, wrist, and hand; embolectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"82088","name":"Assay of aldosterone","description":"Aldosterone","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73000","name":"X-ray exam of collar bone","description":"Radiologic examination; clavicle, complete","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1269.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29049","name":"Appl cast figure-of-eight","description":"Application, cast; figure-of-eight","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15823","name":"Blepharp upr eyelid xcsv skn","description":"Blepharoplasty, upper eyelid; with excessive skin weighting down lid","date_of_service":"2026-05-10","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":"88182","name":"Cell marker study","description":"Flow cytometry, cell cycle or dna analysis","date_of_service":"2026-05-10","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":"A4641","name":"Radiopharm dx agent noc","description":"Radiopharmaceutical, diagnostic, not otherwise classified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33973","name":"Insert balloon device","description":"Insertion of intra-aortic balloon assist device through the ascending aorta","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":933.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"P9021","name":"Red blood cells unit","description":"Red blood cells, each unit","date_of_service":"2026-05-10","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":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"23415","name":"Release of shoulder ligament","description":"Coracoacromial ligament release, with or without acromioplasty","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":898.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19380","name":"Revj reconstructed breast","description":"Revision of reconstructed breast (eg, significant removal of tissue, re-advancement and/or re-inset of flaps in autologous reconstruction or significant capsular revision combined with soft tissue excision in implant-based reconstruction)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":832.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":148.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1372.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76101","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"62225","name":"Replace/irrigate catheter","description":"Replacement or irrigation, ventricular catheter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":503.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65782","name":"Ocular reconst transplant","description":"Ocular surface reconstruction; limbal conjunctival autograft (includes obtaining graft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":715.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":772.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":593.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"28600","name":"Treat foot dislocation","description":"Closed treatment of tarsometatarsal joint dislocation; without anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37788","name":"Revascularization penis","description":"Penile revascularization, artery, with or without vein graft","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2040","name":"Hkafo torsion bil rot straps","description":"Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"36800","name":"Insertion of cannula","description":"Insertion of cannula for hemodialysis, other purpose (separate procedure); vein to vein","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80166","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"65781","name":"Ocular reconst transplant","description":"Ocular surface reconstruction; limbal stem cell allograft (eg, cadaveric or living donor)","date_of_service":"2026-05-10","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":"24100","name":"Arthrt elbw synovial bx only","description":"Arthrotomy, elbow; with synovial biopsy only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5940","name":"Endo bk ultra-light material","description":"Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95974","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90747","name":"Hepb vacc 4 dose immunsup im","description":"Hepatitis b vaccine (hepb), dialysis or immunosuppressed patient dosage, 4 dose schedule, for intramuscular use","date_of_service":"2026-05-10","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":170.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0443","name":"Portable 02 contents, gas","description":"Portable oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":416.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"83528","name":"Assay of intrinsic factor","description":"Intrinsic factor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1679.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"54690","name":"Laparoscopy orchiectomy","description":"Laparoscopy, surgical; orchiectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48554","name":"Transpl allograft pancreas","description":"Transplantation of pancreatic allograft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2120.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86140","name":"C-reactive protein","description":"C-reactive protein;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":603.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1375.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6608","name":"G com bandage tub protct pad","description":"Gradient compression bandaging supply, tubular protective absorption padded layer, per linear yard, any width, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4373","name":"Skin barrier with flange","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"0468T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"86157","name":"Cold agglutinin titer","description":"Cold agglutinin; titer","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":767.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77074","name":"Radex osseous survey lmtd","description":"Radiologic examination, osseous survey; limited (eg, for metastases)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0106","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32671","name":"Thoracoscopy pneumonectomy","description":"Thoracoscopy, surgical; with removal of lung (pneumonectomy)","date_of_service":"2026-05-10","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":"27282","name":"Arthrodesis symphysis pubis","description":"Arthrodesis, symphysis pubis (including obtaining graft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33217","name":"Insert 2 electrode pm-defib","description":"Insertion of 2 transvenous electrodes, permanent pacemaker or implantable defibrillator","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2525","name":"Th/wght bear nar m-l brim mo","description":"Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":653.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5979","name":"Multi-axial ankle/ft prosth","description":"All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6585","name":"Grad com wrap w straps ak","description":"Gradient compression wrap with adjustable straps, above knee, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"70332","name":"X-ray exam of jaw joint","description":"Temporomandibular joint arthrography, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"E2223","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1840","name":"Adj shoulder ext/flex device","description":"Dynamic adjustable shoulder flexion / abduction / rotation device, includes soft interface material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"S0191","name":"Misoprostol, oral, 200 mcg","description":"Misoprostol, oral, 200 mcg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27435","name":"Incision of knee joint","description":"Capsulotomy, posterior capsular release, knee","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":900.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74320","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"J1436","name":"Etidronate disodium inj","description":"Injection, etidronate disodium, per 300 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"27415","name":"Osteochondral knee allograft","description":"Osteochondral allograft, knee, open","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1162.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6693","name":"Lockingelbow forearm cntrbal","description":"Upper extremity addition, locking elbow, forearm counterbalance","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"22865","name":"Rmvl tot arthrp 1ntrspc lmbr","description":"Removal of total disc arthroplasty (artificial disc), anterior approach, single interspace; lumbar","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L5848","name":"Knee-shin sys hydraul stance","description":"Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"27535","name":"Treat knee fracture","description":"Open treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1079.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2570","name":"Hip clevis type 2 posit jnt","description":"Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each","date_of_service":"2026-05-10","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":"L6388","name":"Postop applicat rigid dsg on","description":"Immediate post surgical or early fitting, application of rigid dressing only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"A6259","name":"Transparent film > 48 sq in","description":"Transparent film, sterile, more than 48 sq. in., each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6632","name":"Latex suspension sleeve each","description":"Upper extremity addition, latex suspension sleeve, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"57065","name":"Destruction vag lesion xtnsv","description":"Destruction of vaginal lesion(s); extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery)","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"76975","name":"Gi endoscopic ultrasound","description":"Gastrointestinal endoscopic ultrasound, supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"00539","name":"Anes tracheobronchial rcnstj","description":"Anesthesia for tracheobronchial reconstruction","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1999.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"33465","name":"Replace tricuspid valve","description":"Replacement, tricuspid valve, with cardiopulmonary bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2395.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"L5595","name":"Hip disartic sach thermopls","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2205.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82013","name":"Acetylcholinesterase assay","description":"Acetylcholinesterase","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0627","name":"Lo sag ri an/pos pnl pre cst","description":"Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefab","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":550.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73660","name":"X-ray exam of toe(s)","description":"Radiologic examination; toe(s), minimum of 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0186","name":"Air pressure mattress","description":"Air pressure mattress","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"78606","name":"Brain image w/flow 4 + views","description":"Brain imaging, minimum 4 static views; with vascular flow","date_of_service":"2026-05-10","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":"51980","name":"Construct bladder opening","description":"Cutaneous vesicostomy","date_of_service":"2026-05-10","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":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-05-10","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":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":604.76,"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":"E0749","name":"Elec osteogen stim implanted","description":"Osteogenesis stimulator, electrical, surgically implanted","date_of_service":"2026-05-10","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":"L0170","name":"Cervical collar molded to pt","description":"Cervical, collar, molded to patient model","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38120","name":"Laparoscopy splenectomy","description":"Laparoscopy, surgical, splenectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45900","name":"Reduction of rectal prolapse","description":"Reduction of procidentia (separate procedure) under anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0764","name":"Functional neuromuscularstim","description":"Functional neuromuscular stimulation, transcutaneous stimulation of sequential muscle groups of ambulation with computer control, used for walking by spinal cord injured, entire system, after completion of training program","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20926","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54435","name":"Revision of penis","description":"Corpora cavernosa-glans penis fistulization (eg, biopsy needle, winter procedure, rongeur, or punch) for priapism","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8693","name":"Aud osseo dev, abutment","description":"Auditory osseointegrated device abutment, any length, replacement only","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4364","name":"Adhesive, liquid or equal","description":"Adhesive, liquid or equal, any type, per oz","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24310","name":"Tnot opn elbw to sho ea tdn","description":"Tenotomy, open, elbow to shoulder, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":571.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"K0051","name":"Cam rel asm ft/legrst rep ea","description":"Cam release assembly, footrest or legrest, replacement only, each","date_of_service":"2026-05-10","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":"V2309","name":"Lens sphc trifocal 4.25-7/4.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"61544","name":"Remove & treat brain lesion","description":"Craniotomy with elevation of bone flap; for excision or coagulation of choroid plexus","date_of_service":"2026-05-10","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":"84154","name":"Assay of psa free","description":"Prostate specific antigen (psa); free","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82075","name":"Assay of breath ethanol","description":"Alcohol (ethanol); breath","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93926","name":"Lower extremity study","description":"Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1260","name":"Anterior thoracic derotation","description":"Addition to tlso, (low profile), anterior thoracic derotation pad","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"92562","name":"Loudness balance test","description":"Loudness balance test, alternate binaural or monaural","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2376","name":"Expandable controller, repl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"76645","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"40819","name":"Excise lip or cheek fold","description":"Excision of frenum, labial or buccal (frenumectomy, frenulectomy, frenectomy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86870","name":"Rbc antibody identification","description":"Antibody identification, rbc antibodies, each panel for each serum technique","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"63746","name":"Removal of spinal shunt","description":"Removal of entire lumbosubarachnoid shunt system without replacement","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78003","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6233","name":"Hydrogel dressing >48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61793","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1463.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6548","name":"Acces cust grad silic band","description":"Accessory to custom gradient compression garment, silicone band, any size","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"42280","name":"Preparation palate mold","description":"Maxillary impression for palatal prosthesis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1855.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5714","name":"Knee-shin exo variable frict","description":"Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control","date_of_service":"2026-05-10","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":"L3901","name":"Hinge ext/flex wrist finger","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87103","name":"Blood fungus culture","description":"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; blood","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5638","name":"Below knee leather socket","description":"Addition to lower extremity, below knee, leather socket","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1227.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-10","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":"63195","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35450","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":658.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"00537","name":"Anes cardiac ep procedures","description":"Anesthesia for cardiac electrophysiologic procedures including radiofrequency ablation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L0452","name":"Tlso flex custom fab thoraci","description":"Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, custom fabricated","date_of_service":"2026-05-10","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":"90819","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32654","name":"Thoracoscopy contrl bleeding","description":"Thoracoscopy, surgical; with control of traumatic hemorrhage","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":914.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"93720","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"35459","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5616","name":"Ak univ multiplex sys frict","description":"Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control","date_of_service":"2026-05-10","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":"A4418","name":"Ost pch clsd w/o bar w filtr","description":"Ostomy pouch, closed; without barrier attached, with filter (1 piece), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"21215","name":"Lower jaw bone graft","description":"Graft, bone; mandible (includes obtaining graft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V5266","name":"Battery for hearing device","description":"Battery for use in hearing device","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27390","name":"Incision of thigh tendon","description":"Tenotomy, open, hamstring, knee to hip; single tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4616","name":"Tubing (oxygen) per foot","description":"Tubing (oxygen), per foot","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82383","name":"Assay blood catecholamines","description":"Catecholamines; blood","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1829","name":"Adjust toe flexion device","description":"Dynamic adjustable toe flexion only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33979","name":"Insert intracorporeal device","description":"Insertion of ventricular assist device, implantable intracorporeal, single ventricle","date_of_service":"2026-05-10","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":"28810","name":"Amputation toe & metatarsal","description":"Amputation, metatarsal, with toe, single","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8610","name":"Ocular implant","description":"Ocular implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"V2710","name":"Glass/plastic slab off prism","description":"Slab off prism, glass or plastic, per lens","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2020","name":"Linezolid injection","description":"Injection, linezolid, 200 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1159.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33735","name":"Revision of heart chamber","description":"Atrial septectomy or septostomy; closed heart (blalock-hanlon type operation)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1415.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"G0111","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"64575","name":"Opn impltj nea perph nerve","description":"Open implantation of neurostimulator electrode array; peripheral nerve (excludes sacral nerve)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3905","name":"Who w/nontorsion jnt(s) cf","description":"Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77084","name":"Mri bone marrow blood supply","description":"Magnetic resonance (eg, proton) imaging, bone marrow blood supply","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"47562","name":"Laparoscopic cholecystectomy","description":"Laparoscopy, surgical; cholecystectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":549.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"A4356","name":"Ext ureth clmp or compr dvc","description":"External urethral clamp or compression device (not to be used for catheter clamp), each","date_of_service":"2026-05-10","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":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KM"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-10","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":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"36563","name":"Insert tunneled cv cath","description":"Insertion of tunneled centrally inserted central venous access device with subcutaneous pump","date_of_service":"2026-05-10","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":"29710","name":"Rmvl/bivlv sho/hip spica","description":"Removal or bivalving; shoulder or hip spica, minerva, or risser jacket, etc.","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53665","name":"Dilation of urethra","description":"Dilation of female urethra, general or conduction (spinal) anesthesia","date_of_service":"2026-05-10","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":"92565","name":"Stenger test pure tone","description":"Stenger test, pure tone","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":303.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87481","name":"Candida dna amp probe","description":"Infectious agent detection by nucleic acid (dna or rna); candida species, amplified probe technique","date_of_service":"2026-05-10","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":"E1172","name":"Wheelchair amputee detach ar","description":"Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8045","name":"Auricular prosthesis","description":"Auricular prosthesis, provided by a non-physician","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1358.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KM","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43219","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85008","name":"Bl smear w/o diff wbc count","description":"Blood count; blood smear, microscopic examination without manual differential wbc count","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2208","name":"Lens sphcy bifocal 4.25-7/2.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"91011","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6625","name":"Rotation wrst w/ cable lock","description":"Upper extremity addition, rotation wrist unit with cable lock","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0236T","name":"Trluml perip athrc abd aorta","description":"Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation; abdominal aorta","date_of_service":"2026-05-10","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":"21026","name":"Excision of facial bone(s)","description":"Excision of bone (eg, for osteomyelitis or bone abscess); facial bone(s)","date_of_service":"2026-05-10","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":"E1805","name":"Adjust wrist ext & flex dev","description":"Dynamic adjustable wrist extension and flexion device, includes soft interface material","date_of_service":"2026-05-10","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":"77409","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"76870","name":"Us exam scrotum","description":"Ultrasound, scrotum and contents","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6531","name":"Compress stking bk30-40 surg","description":"Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["AW"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90696","name":"Dtap-ipv vaccine 4-6 yrs im","description":"Diphtheria, tetanus toxoids, acellular pertussis vaccine and inactivated poliovirus vaccine (dtap-ipv), when administered to children 4 through 6 years of age, for intramuscular use","date_of_service":"2026-05-10","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":73.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L7366","name":"Battery chrgr 12 volt utah/e","description":"Battery charger, twelve volt, each","date_of_service":"2026-05-10","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":"A6442","name":"Conform band n/s w<3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00550","name":"Anes for sternal debridement","description":"Anesthesia for sternal debridement","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"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":"L6881","name":"Term dev auto grasp feature","description":"Automatic grasp feature, addition to upper limb electric prosthetic terminal device","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00520","name":"Anes closed chest px nos","description":"Anesthesia for closed chest procedures; (including bronchoscopy) not otherwise specified","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":985.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80102","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"55700","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"75680","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J9040","name":"Bleomycin sulfate injection","description":"Injection, bleomycin sulfate, 15 units","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"95936","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6599","name":"G comp bandage short stretch","description":"Gradient compression bandage roll, inelastic short stretch, per linear yard, any width, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"51040","name":"Incise & drain bladder","description":"Cystostomy, cystotomy with drainage","date_of_service":"2026-05-10","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":"57335","name":"Repair vagina","description":"Vaginoplasty for intersex state","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00916","name":"Anes trurl px rescj bleeding","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); post-transurethral resection bleeding","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75822","name":"Vein x-ray arms/legs","description":"Venography, extremity, bilateral, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"44212","name":"Laparo total proctocolectomy","description":"Laparoscopy, surgical; colectomy, total, abdominal, with proctectomy, with ileostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2207.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":477.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0651","name":"Lso sag-co shell pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by ove","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["26"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40490","name":"Biopsy of lip","description":"Biopsy of lip","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6704","name":"Term dev, sport/rec/work att","description":"Terminal device, sport/recreational/work attachment, any material, any size","date_of_service":"2026-05-10","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":"19318","name":"Breast reduction","description":"Breast reduction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":708.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5654","name":"Socket insert symes","description":"Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"96900","name":"Actinotherapy uv light","description":"Actinotherapy (ultraviolet light)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1148.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2415","name":"Knee joint cam lock each joi","description":"Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67805","name":"Remove eyelid lesions","description":"Excision of chalazion; multiple, different lids","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90717","name":"Yellow fever vaccine subq","description":"Yellow fever vaccine, live, for subcutaneous use","date_of_service":"2026-05-10","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":49.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42550","name":"Injection for salivary x-ray","description":"Injection procedure for sialography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":164.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8041","name":"Midfacial prosthesis","description":"Midfacial prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.16,"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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"43631","name":"Removal of stomach partial","description":"Gastrectomy, partial, distal; with gastroduodenostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1544.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83903","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"G0438","name":"Ppps, initial visit","description":"Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4311","name":"Catheter w/o bag 2-way latex","description":"Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.)","date_of_service":"2026-05-10","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":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"83891","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":991.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50782","name":"Reimplant ureter in bladder","description":"Ureteroneocystostomy; anastomosis of duplicated ureter to bladder","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2070","name":"Hkafo torsion unilat rot str","description":"Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":735.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72084","name":"X-ray exam entire spi 6/> vw","description":"Radiologic examination, spine, entire thoracic and lumbar, including skull, cervical and sacral spine if performed (eg, scoliosis evaluation); minimum of 6 views","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"78010","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"73630","name":"X-ray exam of foot","description":"Radiologic examination, foot; complete, minimum of 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1232","name":"Folding ped wc tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system","date_of_service":"2026-05-10","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":"61570","name":"Remove foreign body brain","description":"Craniectomy or craniotomy; with excision of foreign body from brain","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35907","name":"Excision graft abdomen","description":"Excision of infected graft; abdomen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1681.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27178","name":"Treat slipped epiphysis","description":"Open treatment of slipped femoral epiphysis; closed manipulation with single or multiple pinning","date_of_service":"2026-05-10","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":"00148","name":"Anes px eye ophthalmoscopy","description":"Anesthesia for procedures on eye; ophthalmoscopy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"L2128","name":"Kafo fem fx cast molded to p","description":"Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated","date_of_service":"2026-05-10","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":"15420","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"60220","name":"Partial removal of thyroid","description":"Total thyroid lobectomy, unilateral; with or without isthmusectomy","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6707","name":"Term dev mech hook vol close","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"21242","name":"Reconstruction of jaw joint","description":"Arthroplasty, temporomandibular joint, with allograft","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"E0373","name":"Nonpowered pressure mattress","description":"Nonpowered advanced pressure reducing mattress","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83070","name":"Assay of hemosiderin qual","description":"Hemosiderin, qualitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"78596","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"23106","name":"Arthrotomy strnclav joint","description":"Arthrotomy; sternoclavicular joint, with synovectomy, with or without biopsy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"86255","name":"Fluorescent antibody screen","description":"Fluorescent noninfectious agent antibody; screen, each antibody","date_of_service":"2026-05-10","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":"E1223","name":"Wheelchair spec size w foot","description":"Wheelchair with detachable arms, footrests","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":872.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"96152","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4270.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"72192","name":"Ct pelvis w/o dye","description":"Computed tomography, pelvis; without contrast material","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":434.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49652","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":620.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-10","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":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-10","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":"E1830","name":"Adjust toe ext & flex device","description":"Dynamic adjustable toe extension and flexion device, includes soft interface material","date_of_service":"2026-05-10","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":"95833","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0738","name":"Portable gas oxygen system","description":"Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["MS"]}],"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":"2026-05-10","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":"83050","name":"Hgb methemoglobin quan","description":"Hemoglobin; methemoglobin, quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2308","name":"Lens sphc trifocal 4.25-7/2.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1221.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3491.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A5126","name":"Disk/foam pad +or- adhesive","description":"Adhesive or non-adhesive; disk or foam pad","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"42320","name":"Drainage of salivary gland","description":"Drainage of abscess; submaxillary, external","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":208.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30400","name":"Reconstruction of nose","description":"Rhinoplasty, primary; lateral and alar cartilages and/or elevation of nasal tip","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1207.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2222","name":"Solid caster integ whl, repl","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":503.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","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":"32036","name":"Thoracostomy w/flap drainage","description":"Thoracostomy; with open flap drainage for empyema","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":790.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"51920","name":"Close bladder-uterus fistula","description":"Closure of vesicouterine fistula;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1815","name":"Adjust ankle ext & flex dev","description":"Dynamic adjustable ankle extension and flexion device, includes soft interface material","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8617","name":"Coch implant trans coil repl","description":"Transmitting coil for use with cochlear implant device, replacement","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":307.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1096.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"57423","name":"Repair paravag defect lap","description":"Paravaginal defect repair (including repair of cystocele, if performed), laparoscopic approach","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":529.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2387","name":"Add le poly knee custom kafo","description":"Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"88108","name":"Cytopath concentrate tech","description":"Cytopathology, concentration technique, smears and interpretation (eg, saccomanno technique)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86793","name":"Yersinia antibody","description":"Antibody; yersinia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"35565","name":"Art byp grft iliofemoral","description":"Bypass graft, with vein; iliofemoral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"44125","name":"Removal of small intestine","description":"Enterectomy, resection of small intestine; with enterostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1202.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"50840","name":"Replace ureter by bowel","description":"Replacement of all or part of ureter by intestine segment, including intestine anastomosis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"48556","name":"Removal allograft pancreas","description":"Removal of transplanted pancreatic allograft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1062.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2680","name":"Thorac cont lat support upri","description":"Addition to lower extremity, thoracic control, lateral support uprights","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0434","name":"Portable liquid 02","description":"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"38230","name":"Bone marrow harvest allogen","description":"Bone marrow harvesting for transplantation; allogeneic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01772","name":"Anes art upr arm&elbw emblc","description":"Anesthesia for procedures on arteries of upper arm and elbow; embolectomy","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86729","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"64418","name":"Njx aa&/strd sprscap nrv","description":"Injection(s), anesthetic agent(s) and/or steroid; suprascapular nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"B4164","name":"Parenteral 50% dextrose solu","description":"Parenteral nutrition solution: carbohydrates (dextrose), 50% or less (500 ml = 1 unit) - home mix","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","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":"K0835","name":"Pwc gp2 std sing pow opt s/b","description":"Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3966.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4930","name":"Sterile, gloves per pair","description":"Gloves, sterile, per pair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"0249T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78660","name":"Nuclear exam of tear flow","description":"Radiopharmaceutical dacryocystography","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1090","name":"Lumbar sling","description":"Addition to ctlso or scoliosis orthosis, lumbar sling","date_of_service":"2026-05-10","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":"00922","name":"Anes px male gent sem ves","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); seminal vesicles","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"A4405","name":"Nonpectin based ostomy paste","description":"Ostomy skin barrier, non-pectin based, paste, per ounce","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":218.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"21750","name":"Repair of sternum separation","description":"Closure of median sternotomy separation with or without debridement (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":829.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","date_of_service":"2026-05-10","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":"72074","name":"X-ray exam thorac spine4/>vw","description":"Radiologic examination, spine; thoracic, minimum of 4 views","date_of_service":"2026-05-10","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":"84202","name":"Assay rbc protoporphyrin","description":"Protoporphyrin, rbc; quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"70360","name":"X-ray exam of neck","description":"Radiologic examination; neck, soft tissue","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33980","name":"Remove intracorporeal device","description":"Removal of ventricular assist device, implantable intracorporeal, single ventricle","date_of_service":"2026-05-10","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":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":"E2223","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KC"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1836.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"A4333","name":"Urinary cath anchor device","description":"Urinary catheter anchoring device, adhesive skin attachment, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66920","name":"Extraction of lens","description":"Removal of lens material; intracapsular","date_of_service":"2026-05-10","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":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","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":"85018","name":"Hemoglobin","description":"Blood count; hemoglobin (hgb)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54437","name":"Repair corporeal tear","description":"Repair of traumatic corporeal tear(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4399","name":"Ostomy irrig cone/cath w brs","description":"Ostomy irrigation supply; cone/catheter, with or without brush","date_of_service":"2026-05-10","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":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"77777","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62269","name":"Needle biopsy spinal cord","description":"Biopsy of spinal cord, percutaneous needle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82649","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5988","name":"Vertical shock reducing pylo","description":"Addition to lower limb prosthesis, vertical shock reducing pylon feature","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8035","name":"Custom breast prosthesis","description":"Custom breast prosthesis, post mastectomy, molded to patient model","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4639","name":"Infrared ht sys replcmnt pad","description":"Replacement pad for infrared heating pad system, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":808.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86585","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"99318","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0806","name":"Pov group 2 std up to 300lbs","description":"Power operated vehicle, group 2 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"76827","name":"Echo exam of fetal heart","description":"Doppler echocardiography, fetal, pulsed wave and/or continuous wave with spectral display; complete","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58290","name":"Vag hyst complex","description":"Vaginal hysterectomy, for uterus greater than 250 g;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":740.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77315","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J3355","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":474.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"26715","name":"Treat knuckle dislocation","description":"Open treatment of metacarpophalangeal dislocation, single, includes internal fixation, when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":556.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1185.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78597","name":"Lung perfusion differential","description":"Quantitative differential pulmonary perfusion, including imaging when performed","date_of_service":"2026-05-10","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":"69706","name":"Nps surg dilat eust tube bi","description":"Nasopharyngoscopy, surgical, with dilation of eustachian tube (ie, balloon dilation); bilateral","date_of_service":"2026-05-10","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":"77014","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"35840","name":"Explore abdominal vessels","description":"Exploration for postoperative hemorrhage, thrombosis or infection; abdomen","date_of_service":"2026-05-10","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":"43496","name":"Free jejunum flap microvasc","description":"Free jejunum transfer with microvascular anastomosis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21453","name":"Cltx mndblr fx ntrdntl fixj","description":"Closed treatment of mandibular fracture with interdental fixation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01200","name":"Anes all closed px hip joint","description":"Anesthesia for all closed procedures involving hip joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"71260","name":"Ct thorax dx c+","description":"Computed tomography, thorax, diagnostic; with contrast material(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"77470","name":"Special radiation treatment","description":"Special treatment procedure (eg, total body irradiation, hemibody radiation, per oral or endocavitary irradiation)","date_of_service":"2026-05-10","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":"86147","name":"Cardiolipin antibody ea ig","description":"Cardiolipin (phospholipid) antibody, each ig class","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87102","name":"Fungus isolation culture","description":"Culture, fungi (mold or yeast) isolation, with presumptive identification of isolates; other source (except blood)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"72200","name":"X-ray exam si joints","description":"Radiologic examination, sacroiliac joints; less than 3 views","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":141.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2100","name":"Bld glucose monitor w voice","description":"Blood glucose monitor with integrated voice synthesizer","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2090","name":"Hkafo unilat torsion ball br","description":"Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01215","name":"Anes opn revj tot hip arthrp","description":"Anesthesia for open procedures involving hip joint; revision of total hip arthroplasty","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-05-10","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":"99188","name":"App topical fluoride varnish","description":"Application of topical fluoride varnish by a physician or other qualified health care professional","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"73530","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64822","name":"Sympathectomy ulnar artery","description":"Sympathectomy; ulnar artery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5052","name":"Clsd ostomy pouch w/o barr","description":"Ostomy pouch, closed; without barrier attached (1 piece), each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"92561","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2526.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0735","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"27470","name":"Repair of thigh","description":"Repair, nonunion or malunion, femur, distal to head and neck; without graft (eg, compression technique)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"95827","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86308","name":"Heterophile antibody screen","description":"Heterophile antibodies; screening","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"J0530","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"59020","name":"Fetal contract stress test","description":"Fetal contraction stress test","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"68371","name":"Harvest eye tissue alograft","description":"Harvesting conjunctival allograft, living donor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J0560","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"62180","name":"Establish brain cavity shunt","description":"Ventriculocisternostomy (torkildsen type operation)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00145","name":"Anes px eye vitreortnl surg","description":"Anesthesia for procedures on eye; vitreoretinal surgery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":688.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J9096","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","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":"15851","name":"Removal sutr/staple req anes","description":"Removal of sutures or staples requiring anesthesia (ie, general anesthesia, moderate sedation)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01130","name":"Anes body cast appl/revj","description":"Anesthesia for body cast application or revision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":699.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L4110","name":"Repl leath cuff kafo-afo cal","description":"Replace leather cuff kafo-afo, calf or distal thigh","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"47605","name":"Cholecystectomy w/cholang","description":"Cholecystectomy; with cholangiography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":939.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82488","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0640","name":"Fixed patient lift system","description":"Patient lift, fixed system, includes all components/accessories","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27380","name":"Repair of kneecap tendon","description":"Suture of infrapatellar tendon; primary","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2104","name":"Spherocylindr 4.00d/2.12-4d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2378","name":"Pw actuator replacement","description":"Power wheelchair component, actuator, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-10","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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33724","name":"Repair venous anomaly","description":"Repair of isolated partial anomalous pulmonary venous return (eg, scimitar syndrome)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1337.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77615","name":"Hyperthermia ntrstl prb>5","description":"Hyperthermia generated by interstitial probe(s); more than 5 interstitial applicators","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":466.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28108","name":"Removal of toe lesions","description":"Excision or curettage of bone cyst or benign tumor, phalanges of foot","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":358.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"84540","name":"Assay of urine/urea-n","description":"Urea nitrogen, urine","date_of_service":"2026-05-10","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":"0209T","name":"Audiometry air & bone","description":"Pure tone audiometry (threshold), automated; air and bone","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2611","name":"Gen use back cush wdth <22in","description":"General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2620.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":827.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":920.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72040","name":"X-ray exam neck spine 2-3 vw","description":"Radiologic examination, spine, cervical; 2 or 3 views","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"23333","name":"Remove shoulder fb deep","description":"Removal of foreign body, shoulder; deep (subfascial or intramuscular)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L3224","name":"Womans shoe oxford brace","description":"Orthopedic footwear, womans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0277","name":"Powered pres-redu air mattrs","description":"Powered pressure-reducing air mattress","date_of_service":"2026-05-10","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":"25622","name":"Cltx carpl scphd fx w/o mnpj","description":"Closed treatment of carpal scaphoid (navicular) fracture; without manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":932.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"00142","name":"Anes px on eye lens surgery","description":"Anesthesia for procedures on eye; lens surgery","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"A8003","name":"Hard protect helmet custom","description":"Helmet, protective, hard, custom fabricated, includes all components and accessories","date_of_service":"2026-05-10","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":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28062","name":"Removal of foot fascia","description":"Fasciectomy, plantar fascia; radical (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":510.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","date_of_service":"2026-05-10","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":"L6640","name":"Shoulder abduction joint pai","description":"Upper extremity additions, shoulder abduction joint, pair","date_of_service":"2026-05-10","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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49422","name":"Remove tunneled ip cath","description":"Removal of tunneled intraperitoneal catheter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1186.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":52.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":672.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1274.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0745","name":"Neuromuscular stim for shock","description":"Neuromuscular stimulator, electronic shock unit","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"Q0115","name":"Post-coital mucous exam","description":"Post-coital direct, qualitative examinations of vaginal or cervical mucous","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":644.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69960","name":"Release inner ear canal","description":"Decompression internal auditory canal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2192.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","date_of_service":"2026-05-10","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":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00539","name":"Anes tracheobronchial rcnstj","description":"Anesthesia for tracheobronchial reconstruction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76519","name":"Echo exam of eye","description":"Ophthalmic biometry by ultrasound echography, a-scan; with intraocular lens power calculation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45395","name":"Lap removal of rectum","description":"Laparoscopy, surgical; proctectomy, complete, combined abdominoperineal, with colostomy","date_of_service":"2026-05-10","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":"80184","name":"Assay of phenobarbital","description":"Phenobarbital","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83021","name":"Hemoglobin chromotography","description":"Hemoglobin fractionation and quantitation; chromatography (eg, a2, s, c, and/or f)","date_of_service":"2026-05-10","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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"27437","name":"Revise kneecap","description":"Arthroplasty, patella; without prosthesis","date_of_service":"2026-05-10","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":"83909","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"01844","name":"Anes vasc shunt/shunt revj","description":"Anesthesia for vascular shunt, or shunt revision, any type (eg, dialysis)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"33975","name":"Implant ventricular device","description":"Insertion of ventricular assist device; extracorporeal, single ventricle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1804","name":"Adjust elbow flexion dev","description":"Dynamic adjustable elbow flexion only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69100","name":"Biopsy of external ear","description":"Biopsy external ear","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1701","name":"Repl cushions for jaw motion","description":"Replacement cushions for jaw motion rehabilitation system, pkg. of 6","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30210","name":"Nasal sinus therapy","description":"Displacement therapy (proetz type)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1513.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L2000","name":"Kafo sing fre stirr thi/calf","description":"Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ak orthosis), custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76948","name":"Echo guide ova aspiration","description":"Ultrasonic guidance for aspiration of ova, imaging supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5051","name":"Pouch clsd w barr attached","description":"Ostomy pouch, closed; with barrier attached (1 piece), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":651.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58740","name":"Adhesiolysis tube ovary","description":"Lysis of adhesions (salpingolysis, ovariolysis)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1016.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6382","name":"Postop dsg cast chg elb dis/","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"75685","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"A6443","name":"Conform band n/s w>=3in<5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0362","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"60200","name":"Remove thyroid lesion","description":"Excision of cyst or adenoma of thyroid, or transection of isthmus","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"80156","name":"Assay carbamazepine total","description":"Carbamazepine; total","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00220","name":"Anes icr px csf shunting px","description":"Anesthesia for intracranial procedures; cerebrospinal fluid shunting procedures","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":198.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5986","name":"Multi-axial rotation unit","description":"All lower extremity prostheses, multi-axial rotation unit (mcp or equal)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2120","name":"Pulse gen sys tx endolymp fl","description":"Pulse generator system for tympanic treatment of inner ear endolymphatic fluid","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"99337","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73600","name":"X-ray exam of ankle","description":"Radiologic examination, ankle; 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23172","name":"Sequestrectomy scapula","description":"Sequestrectomy (eg, for osteomyelitis or bone abscess), scapula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L5987","name":"Shank ft w vert load pylon","description":"All lower extremity prosthesis, shank foot system with vertical loading pylon","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"E0733","name":"Trans elec nerv for trigemin","description":"Transcutaneous electrical nerve stimulator for electrical stimulation of the trigeminal nerve","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"43620","name":"Removal of stomach","description":"Gastrectomy, total; with esophagoenterostomy","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64874","name":"Repair & revise nerve add-on","description":"Suture of nerve; requiring extensive mobilization, or transposition of nerve (list separately in addition to code for nerve suture)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6203","name":"Composite drsg <= 16 sq in","description":"Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-10","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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27557","name":"Treat knee dislocation","description":"Open treatment of knee dislocation, includes internal fixation, when performed; with primary ligamentous repair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"E0635","name":"Patient lift electric","description":"Patient lift, electric with seat or sling","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"E0272","name":"Mattress foam rubber","description":"Mattress, foam rubber","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["AV"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9350","name":"Inj mosunetuzumab-axgb, 1 mg","description":"Injection, mosunetuzumab-axgb, 1 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E0635","name":"Patient lift electric","description":"Patient lift, electric with seat or sling","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1833","name":"Ko adj jnt pos r sup pre ots","description":"Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3915","name":"Who nontorsion jnts pre cst","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1163.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0144","name":"Enclosed walker w rear seat","description":"Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"V2531","name":"Contact lens gas permeable","description":"Contact lens, scleral, gas permeable, per lens (for contact lens modification, see 92325)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21490","name":"Optx tmprmand dislocation","description":"Open treatment of temporomandibular dislocation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1071.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":380.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"49420","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61304","name":"Crnec/crnot expl supratntorl","description":"Craniectomy or craniotomy, exploratory; supratentorial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1847.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00802","name":"Anes px lwr abdl wal pannic","description":"Anesthesia for procedures on lower anterior abdominal wall; panniculectomy","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28705","name":"Arthrodesis pantalar","description":"Arthrodesis; pantalar","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1012.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33315","name":"Exploratory heart surgery","description":"Cardiotomy, exploratory (includes removal of foreign body, atrial or ventricular thrombus); with cardiopulmonary bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1637.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"86580","name":"Tb intradermal test","description":"Skin test; tuberculosis, intradermal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"Q9955","name":"Inj perflexane lip micros,ml","description":"Injection, perflexane lipid microspheres, per ml","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"28546","name":"Treat foot dislocation","description":"Percutaneous skeletal fixation of tarsal bone dislocation, other than talotarsal, with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38770","name":"Remove pelvis lymph nodes","description":"Pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes (separate procedure)","date_of_service":"2026-05-10","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":"42440","name":"Excise submaxillary gland","description":"Excision of submandibular (submaxillary) gland","date_of_service":"2026-05-10","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":"33222","name":"Relocation pocket pacemaker","description":"Relocation of skin pocket for pacemaker","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00740","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":957.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-10","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":"71035","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-10","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":"96401","name":"Chemo anti-neopl sq/im","description":"Chemotherapy administration, subcutaneous or intramuscular; non-hormonal anti-neoplastic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0200","name":"Cerv col supp adj bar & thor","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars, and thoracic extension","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"85041","name":"Automated rbc count","description":"Blood count; red blood cell (rbc), automated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"33464","name":"Valvuloplasty tricuspid","description":"Valvuloplasty, tricuspid valve; with ring insertion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2119.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95933","name":"Blink reflex test","description":"Orbicularis oculi (blink) reflex, by electrodiagnostic testing","date_of_service":"2026-05-10","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":"E0600","name":"Suction pump portab hom modl","description":"Respiratory suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83012","name":"Assay of haptoglobins","description":"Haptoglobin; phenotypes","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25500","name":"Cltx rdl shft fx w/o mnpj","description":"Closed treatment of radial shaft fracture; without manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5681","name":"Intl custm cong/latyp insert","description":"Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"3078F","name":"Diast bp <80 mm hg","description":"Most recent diastolic blood pressure less than 80 mm hg (htn, ckd, cad) (dm)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0952","name":"Toe loop/holder, each","description":"Toe loop/holder, any type, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-10","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":"35501","name":"Art byp grft ipsilat carotid","description":"Bypass graft, with vein; common carotid-ipsilateral internal carotid","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1290.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":157.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["TC"]}],"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":"2026-05-10","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":"77051","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"42426","name":"Excise parotid gland/lesion","description":"Excision of parotid tumor or parotid gland; total, with unilateral radical neck dissection","date_of_service":"2026-05-10","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":"75820","name":"Vein x-ray arm/leg","description":"Venography, extremity, unilateral, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0636","name":"Pt support & positioning sys","description":"Multipositional patient support system, with integrated lift, patient accessible controls","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"28173","name":"Resect metatarsal tumor","description":"Radical resection of tumor; metatarsal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28606","name":"Treat foot dislocation","description":"Percutaneous skeletal fixation of tarsometatarsal joint dislocation, with manipulation","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29260","name":"Strapping of elbow or wrist","description":"Strapping; elbow or wrist","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28476","name":"Prq skel fix metar fx w/mnpj","description":"Percutaneous skeletal fixation of metatarsal fracture, with manipulation, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["26"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":826.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24160","name":"Rmvl prosthhumrl&ulnar cmpnt","description":"Removal of prosthesis, includes debridement and synovectomy when performed; humeral and ulnar components","date_of_service":"2026-05-10","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":"77063","name":"Breast tomosynthesis bi","description":"Screening digital breast tomosynthesis, bilateral (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"2026-05-10","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":"74241","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"49020","name":"Drainage abdom abscess open","description":"Drainage of peritoneal abscess or localized peritonitis, exclusive of appendiceal abscess, open","date_of_service":"2026-05-10","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":"87593","name":"Orthopoxvirus amp prb each","description":"Infectious agent detection by nucleic acid (dna or rna); orthopoxvirus (eg, monkeypox virus, cowpox virus, vaccinia virus), amplified probe technique, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85045","name":"Automated reticulocyte count","description":"Blood count; reticulocyte, automated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6603","name":"G com bandge low dn foamchnl","description":"Gradient compression bandaging supply, low density channel foam sheet, per 250 square centimeters, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6196","name":"Alginate dressing <=16 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0167","name":"Dronabinol 2.5mg oral","description":"Dronabinol, 2.5 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1366.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1269.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68110","name":"Exc les conjunctiva <1 cm","description":"Excision of lesion, conjunctiva; up to 1 cm","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4225","name":"Sup/ext insulin inf pump syr","description":"Supplies for external insulin infusion pump, syringe type cartridge, sterile, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1036","name":"Patient transfer system >300","description":"Multi-positional patient transfer system, extra-wide, with integrated seat, operated by caregiver, patient weight capacity greater than 300 lbs","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0744","name":"Neuromuscular stim for scoli","description":"Neuromuscular stimulator for scoliosis","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"94250","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"27340","name":"Removal of kneecap bursa","description":"Excision, prepatellar bursa","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":682.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"58660","name":"Laparoscopy lysis","description":"Laparoscopy, surgical; with lysis of adhesions (salpingolysis, ovariolysis) (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":797.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":921.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"85002","name":"Bleeding time test","description":"Bleeding time","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"50280","name":"Exc/unroofing cyst kidney","description":"Excision or unroofing of cyst(s) of kidney","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":783.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"79440","name":"Nuclear rx intra-articular","description":"Radiopharmaceutical therapy, by intra-articular administration","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"49255","name":"Removal of omentum","description":"Omentectomy, epiploectomy, resection of omentum (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"S8427","name":"Ready gradient glove","description":"Gradient pressure aid (glove), ready made","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88356","name":"Analysis nerve","description":"Morphometric analysis; nerve","date_of_service":"2026-05-10","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":"95910","name":"Nrv cndj test 7-8 studies","description":"Nerve conduction studies; 7-8 studies","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86592","name":"Syphilis test non-trep qual","description":"Syphilis test, non-treponemal antibody; qualitative (eg, vdrl, rpr, art)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42200","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate, soft and/or hard palate only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1057.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"54420","name":"Revision of penis","description":"Corpora cavernosa-saphenous vein shunt (priapism operation), unilateral or bilateral","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"52351","name":"Cystouretero & or pyeloscope","description":"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; diagnostic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":366.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"01180","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"27646","name":"Resect fibula tumor","description":"Radical resection of tumor; fibula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1172.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36148","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85244","name":"Clot factor viii reltd antgn","description":"Clotting; factor viii related antigen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"29000","name":"Appl halo type body cast","description":"Application of halo type body cast (see 20661-20663 for insertion)","date_of_service":"2026-05-10","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":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0940","name":"Trapeze bar free standing","description":"Trapeze bar, free standing, complete with grab bar","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":476.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-10","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":"75833","name":"Vein x-ray kidneys","description":"Venography, renal, bilateral, selective, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":737.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"68700","name":"Repair tear ducts","description":"Plastic repair of canaliculi","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"80156","name":"Assay carbamazepine total","description":"Carbamazepine; total","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","date_of_service":"2026-05-10","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":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0678","name":"Non pneum seq comp full leg","description":"Non-pneumatic sequential compression garment, full leg","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76705","name":"Echo exam of abdomen","description":"Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up)","date_of_service":"2026-05-10","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":"75896","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1160.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88323","name":"Consltj&reprt matrl prep sld","description":"Consultation and report on referred material requiring preparation of slides","date_of_service":"2026-05-10","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":"30160","name":"Rhinectomy total","description":"Rhinectomy; total","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":935.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"52277","name":"Cystoscopy and treatment","description":"Cystourethroscopy, with resection of external sphincter (sphincterotomy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":383.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6442","name":"Conform band n/s w<3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6350","name":"Thoracic intern lock elbow","description":"Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21282","name":"Lateral canthopexy","description":"Lateral canthopexy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":481.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"83894","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":616.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53265","name":"Treatment of urethra lesion","description":"Excision or fulguration; urethral caruncle","date_of_service":"2026-05-10","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":"54620","name":"Suspension of testis","description":"Fixation of contralateral testis (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":338.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","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":"65750","name":"Corneal transplant","description":"Keratoplasty (corneal transplant); penetrating (in aphakia)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"93740","name":"Temperature gradient studies","description":"Temperature gradient studies","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77295","name":"3-d radiotherapy plan","description":"3-dimensional radiotherapy plan, including dose-volume histograms","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1270","name":"Wheelchair lightweight leg r","description":"Lightweight wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":"L7368","name":"Lithium ion battery charger","description":"Lithium ion battery charger, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":246.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4361","name":"Ostomy face plate","description":"Ostomy faceplate, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0855","name":"Pwc gp 3 xhd cap chair","description":"Power wheelchair, group 3 extra heavy duty, captains chair, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2104","name":"Glucose monitor w cartridge","description":"Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"27412","name":"Autochondrocyte implant knee","description":"Autologous chondrocyte implantation, knee","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1936.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51736","name":"Urine flow measurement","description":"Simple uroflowmetry (ufr) (eg, stop-watch flow rate, mechanical uroflowmeter)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"56740","name":"Exc bartholins gland/cyst","description":"Excision of bartholins gland or cyst","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76519","name":"Echo exam of eye","description":"Ophthalmic biometry by ultrasound echography, a-scan; with intraocular lens power calculation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0460","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4681.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78305","name":"Bone imaging multiple areas","description":"Bone and/or joint imaging; multiple areas","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4406","name":"Pectin based ostomy paste","description":"Ostomy skin barrier, pectin-based, paste, per ounce","date_of_service":"2026-05-10","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":"A4651","name":"Calibrated microcap tube","description":"Calibrated microcapillary tube, each","date_of_service":"2026-05-10","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":"90585","name":"Bcg vaccine percut","description":"Bacillus calmette-guerin vaccine (bcg) for tuberculosis, live, for percutaneous use","date_of_service":"2026-05-10","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":215.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","BA","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01916","name":"Anes dx arteriography/vngrph","description":"Anesthesia for diagnostic arteriography/venography","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1664.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KF"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"78185","name":"Spleen imaging","description":"Spleen imaging only, with or without vascular flow","date_of_service":"2026-05-10","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":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"57289","name":"Repair bladder & vagina","description":"Pereyra procedure, including anterior colporrhaphy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":835.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"V2211","name":"Lens sphcy bifo 7.25-12/.25-","description":"Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29085","name":"Appl cast hand&lwr forearm","description":"Application, cast; hand and lower forearm (gauntlet)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33645","name":"Revision of heart veins","description":"Direct or patch closure, sinus venosus, with or without anomalous pulmonary venous drainage","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1805.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"54112","name":"Treat penis lesion graft","description":"Excision of penile plaque (peyronie disease); with graft greater than 5 cm in length","date_of_service":"2026-05-10","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":"L0180","name":"Cer post col occ/man sup adj","description":"Cervical, multiple post collar, occipital/mandibular supports, adjustable","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"46937","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5797.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","date_of_service":"2026-05-10","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":"78191","name":"Platelet survival study","description":"Platelet survival study","date_of_service":"2026-05-10","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":"0072A","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0200","name":"Heat lamp without stand","description":"Heat lamp, without stand (table model), includes bulb, or infrared element","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"74425","name":"Urography antegrade rs&i","description":"Urography, antegrade, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"1126F","name":"Amnt pain noted none prsnt","description":"Pain severity quantified; no pain present (coa) (onc)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"88348","name":"Electron microscopy dx","description":"Electron microscopy, diagnostic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0491","name":"Emr pwr source combo vad rep","description":"Emergency power source for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"62256","name":"Remove brain cavity shunt","description":"Removal of complete cerebrospinal fluid shunt system; without replacement","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":541.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77331","name":"Special radiation dosimetry","description":"Special dosimetry (eg, tld, microdosimetry) (specify), only when prescribed by the treating physician","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"43271","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01404","name":"Anes opn/arthrs disrtcj knee","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; disarticulation at knee","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27266","name":"Treat hip dislocation","description":"Closed treatment of post hip arthroplasty dislocation; requiring regional or general anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21315","name":"Clsd tx nsl fx mnpj wo stblj","description":"Closed treatment of nasal bone fracture with manipulation; without stabilization","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":123.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4554","name":"Disposable underpads","description":"Disposable underpads, all sizes","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"C8900","name":"Mra w/cont, abd","description":"Magnetic resonance angiography with contrast, abdomen","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6154","name":"Wound pouch each","description":"Wound pouch, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","date_of_service":"2026-05-10","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":"50722","name":"Release of ureter","description":"Ureterolysis for ovarian vein syndrome","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1157.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27324","name":"Biopsy thigh soft tissues","description":"Biopsy, soft tissue of thigh or knee area; deep (subfascial or intramuscular)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0441","name":"Stationary o2 contents, gas","description":"Stationary oxygen contents, gaseous, 1 months supply = 1 unit","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"80170","name":"Assay of gentamicin","description":"Gentamicin","date_of_service":"2026-05-10","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":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-10","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":"30930","name":"Ther fx nasal inf turbinate","description":"Fracture nasal inferior turbinate(s), therapeutic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"61680","name":"Intracranial vessel surgery","description":"Surgery of intracranial arteriovenous malformation; supratentorial, simple","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1041.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"J9320","name":"Streptozocin injection","description":"Injection, streptozocin, 1 gram","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":153.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":488.46,"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":"92520","name":"Laryngeal function studies","description":"Laryngeal function studies (ie, aerodynamic testing and acoustic testing)","date_of_service":"2026-05-10","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":"24102","name":"Arthrt elbow w/synovectomy","description":"Arthrotomy, elbow; with synovectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3807","name":"Whfo w/o joints pre cst","description":"Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74320","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33031","name":"Partial removal of heart sac","description":"Pericardiectomy, subtotal or complete; with cardiopulmonary bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1565.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":584.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15320","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0159","name":"Brake for wheeled walker","description":"Brake attachment for wheeled walker, replacement, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":"57307","name":"Fistula repair & colostomy","description":"Closure of rectovaginal fistula; abdominal approach, with concomitant colostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1104.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":781.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"59072","name":"Umbilical cord occlud w/us","description":"Fetal umbilical cord occlusion, including ultrasound guidance","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":467.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1084","name":"Hemi-wheelchair detachable a","description":"Hemi-wheelchair, detachable arms desk or full length arms, swing away detachable elevating leg rests","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"00912","name":"Anes trurl px rescj bldr tum","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of bladder tumor(s)","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00220","name":"Anes icr px csf shunting px","description":"Anesthesia for intracranial procedures; cerebrospinal fluid shunting procedures","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"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":"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":"2026-05-10","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":"90691","name":"Typhoid vaccine im","description":"Typhoid vaccine, vi capsular polysaccharide (vicps), for intramuscular use","date_of_service":"2026-05-10","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":184.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67440","name":"Explore/drain eye socket","description":"Orbitotomy with bone flap or window, lateral approach (eg, kroenlein); with drainage","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":770.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86757","name":"Rickettsia antibody","description":"Antibody; rickettsia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"26992","name":"Drainage of bone lesion","description":"Incision, bone cortex, pelvis and/or hip joint (eg, osteomyelitis or bone abscess)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43500","name":"Surgical opening of stomach","description":"Gastrotomy; with exploration or foreign body removal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":776.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27279","name":"Arthrd si jt plmt tartclr dv","description":"Arthrodesis, sacroiliac joint, percutaneous or minimally invasive, with image guidance, includes obtaining bone graft when performed, unilateral; placement of transarticular device(s) and/or intra-articular device(s) piercing the lateral or medial cortices of the ilium and the lateral cortex of the ","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65779","name":"Cover eye w/membrane suture","description":"Placement of amniotic membrane on the ocular surface; single layer, sutured","date_of_service":"2026-05-10","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":"31760","name":"Tracheoplasty intrathoracic","description":"Tracheoplasty; intrathoracic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1598.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4456","name":"Adhesive remover, wipes","description":"Adhesive remover, wipes, any type, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26542","name":"Repair hand joint with graft","description":"Reconstruction, collateral ligament, metacarpophalangeal joint, single; with local tissue (eg, adductor advancement)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43236","name":"Uppr gi scope w/submuc inj","description":"Esophagogastroduodenoscopy, flexible, transoral; with directed submucosal injection(s), any substance","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"76946","name":"Echo guide for amniocentesis","description":"Ultrasonic guidance for amniocentesis, imaging supervision and interpretation","date_of_service":"2026-05-10","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":"K0606","name":"Aed garment w elec analysis","description":"Automatic external defibrillator, with integrated electrocardiogram analysis, garment type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00474","name":"Anes prtl rib rescj rad px","description":"Anesthesia for partial rib resection; radical procedures (eg, pectus excavatum)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2313","name":"Pwc harness, expand control","description":"Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":"E1296","name":"Wheelchair special seat heig","description":"Special wheelchair seat height from floor","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":478.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86327","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"79300","name":"Nuclr rx interstit colloid","description":"Radiopharmaceutical therapy, by interstitial radioactive colloid administration","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3908","name":"Who cock-up nonmolde pre ots","description":"Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":"ATP20","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"28200","name":"Repair of foot tendon","description":"Repair, tendon, flexor, foot; primary or secondary, without free graft, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":261.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"L5636","name":"Symes type medial opening so","description":"Addition to lower extremity, symes type, medial opening socket","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77328","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":78.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":764.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1168.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"43761","name":"Reposition gastrostomy tube","description":"Repositioning of a naso- or oro-gastric feeding tube, through the duodenum for enteric nutrition","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8681","name":"Pt prgrm for implt neurostim","description":"Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"93970","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6884","name":"Replc sockt above elbow disa","description":"Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75946","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"E0947","name":"Fracture frame attachmnts pe","description":"Fracture frame, attachments for complex pelvic traction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"J1490","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5673","name":"Socket insert w lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","date_of_service":"2026-05-10","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":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L4361","name":"Pneuma/vac walk boot pre ots","description":"Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4233","name":"Alkalin batt for glucose mon","description":"Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1807","name":"Adjust wrist extension dev","description":"Dynamic adjustable wrist extension only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01120","name":"Anes px on bony pelvis","description":"Anesthesia for procedures on bony pelvis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7520","name":"Trach/laryn tube non-cuffed","description":"Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3929","name":"Hfo nontorsion jnts pre cst","description":"Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4408","name":"Ext wear ost skn barr >4sqin","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"72202","name":"X-ray exam si joints 3/> vws","description":"Radiologic examination, sacroiliac joints; 3 or more views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86638","name":"Q fever antibody","description":"Antibody; coxiella burnetii (q fever)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"21445","name":"Optx mndblr/max alv ridge fx","description":"Open treatment of mandibular or maxillary alveolar ridge fracture (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2113","name":"Spherocylindr 7.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","date_of_service":"2026-05-10","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":"78102","name":"Bone marrow imaging ltd","description":"Bone marrow imaging; limited area","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"67923","name":"Repair eyelid defect","description":"Repair of entropion; excision tarsal wedge","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":259.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93971","name":"Extremity study","description":"Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4395","name":"Ostomy pouch solid deodorant","description":"Ostomy deodorant for use in ostomy pouch, solid, per tablet","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L3500","name":"Ortho shoe add leather insol","description":"Orthopedic shoe addition, insole, leather","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6945","name":"Elbow disart myoelectronic c","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"0232T","name":"Njx platelet plasma","description":"Injection(s), platelet rich plasma, any site, including image guidance, harvesting and preparation when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1941.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86609","name":"Bacterium antibody","description":"Antibody; bacterium, not elsewhere specified","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1093.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92611","name":"Motion fluoroscopy/swallow","description":"Motion fluoroscopic evaluation of swallowing function by cine or video recording","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91132","name":"Electrogastrography","description":"Electrogastrography, diagnostic, transcutaneous;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0431","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"47765","name":"Fuse liver ducts & bowel","description":"Anastomosis, of intrahepatic ducts and gastrointestinal tract","date_of_service":"2026-05-10","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":"50125","name":"Pyelotomy w/drg pyelostomy","description":"Pyelotomy; with drainage, pyelostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":793.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26650","name":"Treat thumb fracture","description":"Percutaneous skeletal fixation of carpometacarpal fracture dislocation, thumb (bennett fracture), with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3420","name":"Full sole/heel wedge btween","description":"Full sole and heel wedge, between sole","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":363.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2232","name":"Rocker bottom, contact afo","description":"Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01996","name":"Dly hosp mgmt edrl rx admin","description":"Daily hospital management of epidural or subarachnoid continuous drug administration","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"66625","name":"Removal of iris","description":"Iridectomy, with corneoscleral or corneal section; peripheral for glaucoma (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78650","name":"Csf leakage imaging","description":"Cerebrospinal fluid leakage detection and localization","date_of_service":"2026-05-10","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":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-10","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":"37607","name":"Lig/banding angioacs av fstl","description":"Ligation or banding of angioaccess arteriovenous fistula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96150","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"L1660","name":"Ho abduction static plastic","description":"Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4342","name":"Iduc valve sply repl","description":"Accessories for patient inserted indwelling intraurethral drainage device with valve, replacement only, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"A4310","name":"Insert tray w/o bag/cath","description":"Insertion tray without drainage bag and without catheter (accessories only)","date_of_service":"2026-05-10","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":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1736.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0813","name":"Pwc gp 1 std port seat/back","description":"Power wheelchair, group 1 standard, portable, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"72120","name":"X-ray bend only l-s spine","description":"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views","date_of_service":"2026-05-10","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":"77403","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85041","name":"Automated rbc count","description":"Blood count; red blood cell (rbc), automated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2633","name":"Mobile arm support supinator","description":"Wheelchair accessory, addition to mobile arm support, supinator","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71030","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"35647","name":"Bpg aortofemoral","description":"Bypass graft, with other than vein; aortofemoral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1952.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"60300","name":"Aspir/inj thyroid cyst","description":"Aspiration and/or injection, thyroid cyst","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62304","name":"Myelography lumbar injection","description":"Myelography via lumbar injection, including radiological supervision and interpretation; lumbosacral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":465.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86750","name":"Malaria antibody","description":"Antibody; plasmodium (malaria)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95829","name":"Surgery electrocorticogram","description":"Electrocorticogram at surgery (separate procedure)","date_of_service":"2026-05-10","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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"31320","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"78195","name":"Lymph system imaging","description":"Lymphatics and lymph nodes imaging","date_of_service":"2026-05-10","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":"40720","name":"Repair cleft lip/nasal","description":"Plastic repair of cleft lip/nasal deformity; secondary, by recreation of defect and reclosure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"E0235","name":"Paraffin bath unit portable","description":"Paraffin bath unit, portable (see medical supply code a4265 for paraffin)","date_of_service":"2026-05-10","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":"L1270","name":"Abdominal pad","description":"Addition to tlso, (low profile), abdominal pad","date_of_service":"2026-05-10","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":"59000","name":"Amniocentesis diagnostic","description":"Amniocentesis; diagnostic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"19357","name":"Tiss xpndr plmt brst rcnstj","description":"Tissue expander placement in breast reconstruction, including subsequent expansion(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1670.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5504","name":"Diabetic shoe with wedge","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"37210","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E1232","name":"Folding ped wc tilt-in-space","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, with seating system","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1419.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6245","name":"Hydrogel drg <= 16 in w/bdr","description":"Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"78013","name":"Thyroid imaging w/blood flow","description":"Thyroid imaging (including vascular flow, when performed);","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"58720","name":"Removal of ovary/tube(s)","description":"Salpingo-oophorectomy, complete or partial, unilateral or bilateral (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"77046","name":"Mri breast c- unilateral","description":"Magnetic resonance imaging, breast, without contrast material; unilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1681.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"G0277","name":"Hbot, full body chamber, 30m","description":"Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0261","name":"Hosp bed semi-electr w/o mat","description":"Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J9055","name":"Cetuximab injection","description":"Injection, cetuximab, 10 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27333","name":"Removal of knee cartilage","description":"Arthrotomy, with excision of semilunar cartilage (meniscectomy) knee; medial and lateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":494.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0607","name":"Blood glucose monitor home","description":"Home blood glucose monitor","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38780","name":"Remove abdomen lymph nodes","description":"Retroperitoneal transabdominal lymphadenectomy, extensive, including pelvic, aortic, and renal nodes (separate procedure)","date_of_service":"2026-05-10","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":"27532","name":"Treat knee fracture","description":"Closed treatment of tibial fracture, proximal (plateau); with or without manipulation, with skeletal traction","date_of_service":"2026-05-10","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":"66990","name":"Ophthalmic endoscope add-on","description":"Use of ophthalmic endoscope (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":573.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1014.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":697.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L2300","name":"Abduction bar jointed adjust","description":"Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0570","name":"Buprenorphine implant 74.2mg","description":"Buprenorphine implant, 74.2 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1280","name":"Whchr h-duty det arm leg res","description":"Heavy duty wheelchair, detachable arms (desk or full length) elevating legrests","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85301","name":"Antithrombin iii antigen","description":"Clotting inhibitors or anticoagulants; antithrombin iii, antigen assay","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90818","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27090","name":"Removal of hip prosthesis","description":"Removal of hip prosthesis; (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":997.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":288.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1678.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"27842","name":"Treat ankle dislocation","description":"Closed treatment of ankle dislocation; requiring anesthesia, with or without percutaneous skeletal fixation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3908","name":"Who cock-up nonmolde pre ots","description":"Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"L1901","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"32020","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"L5050","name":"Ank symes mold sckt sach ft","description":"Ankle, symes, molded socket, sach foot","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"59070","name":"Transabdom amnioinfus w/us","description":"Transabdominal amnioinfusion, including ultrasound guidance","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77525","name":"Proton treatment complex","description":"Proton treatment delivery; complex","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1221","name":"Wheelchair spec size w foot","description":"Wheelchair with fixed arm, footrests","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1567.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76880","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97026","name":"Infrared therapy","description":"Application of a modality to 1 or more areas; infrared","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0631","name":"Lso sag r an/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-10","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":"J7130","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2500","name":"Sgd digitized pre-rec <=8min","description":"Speech generating device, digitized speech, using pre-recorded messages, less than or equal to 8 minutes recording time","date_of_service":"2026-05-10","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":"01210","name":"Anes open px hip joint nos","description":"Anesthesia for open procedures involving hip joint; not otherwise specified","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85384","name":"Fibrinogen activity","description":"Fibrinogen; activity","date_of_service":"2026-05-10","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":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"J0895","name":"Deferoxamine mesylate inj","description":"Injection, deferoxamine mesylate, 500 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0791","name":"Parenteral infusion pump sta","description":"Parenteral infusion pump, stationary, single or multi-channel","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1344.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"61612","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1078.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"99201","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83992","name":"Assay for phencyclidine","description":"Phencyclidine (pcp)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"44340","name":"Revision of colostomy","description":"Revision of colostomy; simple (release of superficial scar) (separate procedure)","date_of_service":"2026-05-10","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":"77762","name":"Apply intrcav radiat interm","description":"Intracavitary radiation source application; intermediate","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27606","name":"Incision of achilles tendon","description":"Tenotomy, percutaneous, achilles tendon (separate procedure); general anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":373.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64886","name":"Nerve graft head/neck >4 cm","description":"Nerve graft (includes obtaining graft), head or neck; more than 4 cm length","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3964","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78458","name":"Ven thrombosis images bilat","description":"Venous thrombosis imaging, venogram; bilateral","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"98929","name":"Osteopath manj 9-10 regions","description":"Osteopathic manipulative treatment (omt); 9-10 body regions involved","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20973","name":"Bone/skin graft great toe","description":"Free osteocutaneous flap with microvascular anastomosis; great toe with web space","date_of_service":"2026-05-10","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":"84154","name":"Assay of psa free","description":"Prostate specific antigen (psa); free","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L3310","name":"Shoe lift elev heel/sole neo","description":"Lift, elevation, heel and sole, neoprene, per inch","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"48154","name":"Pancreatectomy","description":"Pancreatectomy, proximal subtotal with near-total duodenectomy, choledochoenterostomy and duodenojejunostomy (pylorus-sparing, whipple-type procedure); without pancreatojejunostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24575","name":"Optx humeral epcndylr fx","description":"Open treatment of humeral epicondylar fracture, medial or lateral, includes internal fixation, when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31730","name":"Intro windpipe wire/tube","description":"Transtracheal (percutaneous) introduction of needle wire dilator/stent or indwelling tube for oxygen therapy","date_of_service":"2026-05-10","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":"40700","name":"Repair cleft lip/nasal","description":"Plastic repair of cleft lip/nasal deformity; primary, partial or complete, unilateral","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"34900","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A9564","name":"P32 chromic phosphate","description":"Chromic phosphate p-32 suspension, therapeutic, per millicurie","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":272.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5646","name":"Below knee cushion socket","description":"Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2205","name":"Lens sphcy bifocal 4.00d/4.2","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":407.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"26665","name":"Treat thumb fracture","description":"Open treatment of carpometacarpal fracture dislocation, thumb (bennett fracture), includes internal fixation, when performed","date_of_service":"2026-05-10","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":"23105","name":"Arthrotomy glenohumeral jt","description":"Arthrotomy; glenohumeral joint, with synovectomy, with or without biopsy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6540","name":"Gc stocking waistlngth 30-40","description":"Gradient compression stocking, waist length, 30-40 mmhg, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"85612","name":"Viper venom prothrombin time","description":"Russell viper venom time (includes venom); undiluted","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"L2034","name":"Kafo pla sin up w/wo k/a cus","description":"Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78215","name":"Lvr&spleen img static only","description":"Liver and spleen imaging; static only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90473","name":"Immune admin oral/nasal","description":"Immunization administration by intranasal or oral route; 1 vaccine (single or combination vaccine/toxoid)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"L0859","name":"Mri compatible system","description":"Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"17360","name":"Chemical exfoliation acne","description":"Chemical exfoliation for acne (eg, acne paste, acid)","date_of_service":"2026-05-10","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":"21045","name":"Extensive jaw surgery","description":"Excision of malignant tumor of mandible; radical resection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"73520","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69000","name":"Drg xtrnl ear absc/hem smpl","description":"Drainage external ear, abscess or hematoma; simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A7017","name":"Nebulizer not used w oxygen","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2375","name":"Non-expandable controller","description":"Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76945","name":"Echo guide villus sampling","description":"Ultrasonic guidance for chorionic villus sampling, imaging supervision and interpretation","date_of_service":"2026-05-10","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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"24151","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33750","name":"Shunt subclavian to pulm art","description":"Shunt; subclavian to pulmonary artery (blalock-taussig type operation)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"86337","name":"Insulin antibodies","description":"Insulin antibodies","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28103","name":"Remove/graft foot lesion","description":"Excision or curettage of bone cyst or benign tumor, talus or calcaneus; with allograft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":543.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":773.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1214.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0225","name":"Hydrocollator unit","description":"Hydrocollator unit, includes pads","date_of_service":"2026-05-10","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":"54380","name":"Repair penis","description":"Plastic operation on penis for epispadias distal to external sphincter;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":647.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1196.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74280","name":"X-ray xm colon 2cntrst std","description":"Radiologic examination, colon, including scout abdominal radiograph(s) and delayed image(s), when performed; double-contrast (eg, high density barium and air) study, including glucagon, when administered","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24371","name":"Revise reconst elbow joint","description":"Revision of total elbow arthroplasty, including allograft when performed; humeral and ulnar component","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2169.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0619","name":"Apnea monitor w recorder","description":"Apnea monitor, with recording feature","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1261.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"64647","name":"Chemodenerv trunk musc 6/>","description":"Chemodenervation of trunk muscle(s); 6 or more muscles","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":188.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["KL","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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5668","name":"Bk molded distal cushion","description":"Addition  to lower extremity, below knee, molded distal cushion","date_of_service":"2026-05-10","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":"96101","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77401","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33875","name":"Thoracic aortic graft","description":"Descending thoracic aorta graft, with or without bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4040","name":"Cast sup shrt leg ped fbrgls","description":"Cast supplies, short leg cast, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6960","name":"Shldr disartic switch contro","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5976.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1528.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15330","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":412.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27006","name":"Tenotomy abductor&/xtnsr hip","description":"Tenotomy, abductors and/or extensor(s) of hip, open (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":884.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6590","name":"Shdr fair lead cable direct","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-10","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":"A4256","name":"Calibrator solution/chips","description":"Normal, low and high calibrator solution / chips","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"49250","name":"Excision of umbilicus","description":"Umbilectomy, omphalectomy, excision of umbilicus (separate procedure)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0325","name":"Urinal male jug-type","description":"Urinal; male, jug-type, any material","date_of_service":"2026-05-10","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":"43410","name":"Repair esophagus wound","description":"Suture of esophageal wound or injury; cervical approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":795.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0053","name":"Elevate footrest articulate","description":"Elevating footrests, articulating (telescoping), each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":801.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27722","name":"Repair/graft of tibia","description":"Repair of nonunion or malunion, tibia; with sliding graft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-05-10","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":"00520","name":"Anes closed chest px nos","description":"Anesthesia for closed chest procedures; (including bronchoscopy) not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"K0859","name":"Pwc gp3 hd sing pow opt cap","description":"Power wheelchair, group 3 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26037","name":"Decompress fingers/hand","description":"Decompressive fasciotomy, hand (excludes 26035)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8618","name":"Coch implant tran cable repl","description":"Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J0580","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27519","name":"Treat thigh fx growth plate","description":"Open treatment of distal femoral epiphyseal separation, includes internal fixation, when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1329.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1129.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95904","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0147","name":"Walker variable wheel resist","description":"Walker, heavy duty, multiple braking system, variable wheel resistance","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":215.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32440","name":"Remove lung pneumonectomy","description":"Removal of lung, pneumonectomy;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1861.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6605","name":"Single pivot hinge pair","description":"Upper extremity additions, single pivot hinge, pair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86885","name":"Coombs test indirect qual","description":"Antihuman globulin test (coombs test); indirect, qualitative, each reagent red cell","date_of_service":"2026-05-10","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":"L2116","name":"Afo tibial fracture rigid","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":"A4418","name":"Ost pch clsd w/o bar w filtr","description":"Ostomy pouch, closed; without barrier attached, with filter (1 piece), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"26496","name":"Revise thumb tendon","description":"Opponensplasty; other methods","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1117.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0624","name":"Sio panel custom","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","date_of_service":"2026-05-10","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":"19350","name":"Nipple/areola reconstruction","description":"Nipple/areola reconstruction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":795.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":847.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":719.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2325","name":"Sip and puff interface","description":"Power wheelchair accessory, sip and puff interface, nonproportional, including all related electronics, mechanical stop switch, and manual swingaway mounting hardware","date_of_service":"2026-05-10","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":"80170","name":"Assay of gentamicin","description":"Gentamicin","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q2017","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":263.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"36420","name":"Venipuncture cutdown < 1 yr","description":"Venipuncture, cutdown; younger than age 1 year","date_of_service":"2026-05-10","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":"79005","name":"Nuclear rx oral admin","description":"Radiopharmaceutical therapy, by oral administration","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15842","name":"Nerve palsy microsurg graft","description":"Graft for facial nerve paralysis; free muscle flap by microsurgical technique","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15819","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":247.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11971","name":"Rmvl tis xpndr wo insj implt","description":"Removal of tissue expander without insertion of implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":304.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":355.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33240","name":"Insrt pulse gen w/singl lead","description":"Insertion of implantable defibrillator pulse generator only; with existing single lead","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1474.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0217","name":"Water circ heat pad w pump","description":"Water circulating heat pad with pump","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"70545","name":"Mr angiography head w/dye","description":"Magnetic resonance angiography, head; with contrast material(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0301","name":"Hd hosp bed, 350-600 lbs","description":"Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, without mattress","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1696.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23221","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61888","name":"Revise/remove neuroreceiver","description":"Revision or removal of cranial neurostimulator pulse generator or receiver","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3960.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"37232","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7017","name":"Nebulizer not used w oxygen","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, not used with oxygen","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5790","name":"Exoskeletal ak ultra-light m","description":"Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"43401","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"15343","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":489.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2597","name":"Inj desmopressin acetate","description":"Injection, desmopressin acetate, per 1 mcg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4234","name":"J-cell batt for glucose mon","description":"Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-10","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":"29590","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68745","name":"Create tear duct drain","description":"Conjunctivorhinostomy (fistulization of conjunctiva to nasal cavity); without tube","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95071","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A6247","name":"Hydrogel drg > 48 sq in w/b","description":"Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-10","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":"A6257","name":"Transparent film <= 16 sq in","description":"Transparent film, sterile, 16 sq. in. or less, each dressing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"84275","name":"Assay of sialic acid","description":"Sialic acid","date_of_service":"2026-05-10","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":"61537","name":"Removal of brain tissue","description":"Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, without electrocorticography during surgery","date_of_service":"2026-05-10","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":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"49656","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1771.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33244","name":"Remove elctrd transvenously","description":"Removal of single or dual chamber implantable defibrillator electrode(s); by transvenous extraction","date_of_service":"2026-05-10","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":"86155","name":"Chemotaxis assay","description":"Chemotaxis assay, specify method","date_of_service":"2026-05-10","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":"33321","name":"Repair major vessel","description":"Suture repair of aorta or great vessels; with shunt bypass","date_of_service":"2026-05-10","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":"76120","name":"Cine/video x-rays","description":"Cineradiography/videoradiography, except where specifically included","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77058","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52282","name":"Cystoscopy implant stent","description":"Cystourethroscopy, with insertion of permanent urethral stent","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"32484","name":"Segmentectomy","description":"Removal of lung, other than pneumonectomy; single segment (segmentectomy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1157.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78609","name":"Brain imaging (pet)","description":"Brain imaging, positron emission tomography (pet); perfusion evaluation","date_of_service":"2026-05-10","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":"63182","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1702.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1205.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57800","name":"Dilation of cervical canal","description":"Dilation of cervical canal, instrumental (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74190","name":"Peritoneogram rs&i","description":"Peritoneogram (eg, after injection of air or contrast), radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0316","name":"Bed safety enclosure","description":"Safety enclosure frame/canopy for use with hospital bed, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"64620","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent, intercostal nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78740","name":"Ureteral reflux study","description":"Ureteral reflux study (radiopharmaceutical voiding cystogram)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33800","name":"Aortic suspension","description":"Aortic suspension (aortopexy) for tracheal decompression (eg, for tracheomalacia) (separate procedure)","date_of_service":"2026-05-10","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":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-10","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":"92950","name":"Heart/lung resuscitation cpr","description":"Cardiopulmonary resuscitation (eg, in cardiac arrest)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3764","name":"Ewho w/joint(s) cf","description":"Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"84087","name":"Assay phosphohexose enzymes","description":"Phosphohexose isomerase","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"77315","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4410","name":"Ost skn barr extnd >4 sq","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0464","name":"Tlso 4mod sacro-scap pre","description":"Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, corona","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1230","name":"Milwaukee type superstructur","description":"Addition to tlso, (low profile), milwaukee type superstructure","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95975","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","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":"A6022","name":"Collagen drsg>16<=48 sq in","description":"Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27200","name":"Treat tail bone fracture","description":"Closed treatment of coccygeal fracture","date_of_service":"2026-05-10","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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55100","name":"Drainage of scrotum abscess","description":"Drainage of scrotal wall abscess","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1095.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"84135","name":"Assay of pregnanediol","description":"Pregnanediol","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"55180","name":"Revision of scrotum","description":"Scrotoplasty; complicated","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77763","name":"Apply intrcav radiat compl","description":"Intracavitary radiation source application; complex","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77328","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"64820","name":"Sympathectomy digital artery","description":"Sympathectomy; digital arteries, each digit","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"78597","name":"Lung perfusion differential","description":"Quantitative differential pulmonary perfusion, including imaging when performed","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1512.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28436","name":"Prq skel fix talus fx w/mnpj","description":"Percutaneous skeletal fixation of talus fracture, with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20250","name":"Biopsy vrt bdy open thoracic","description":"Biopsy, vertebral body, open; thoracic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":343.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93532","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6562","name":"G com stckng waist18-30 cust","description":"Gradient compression stocking, waist length, 18-30 mmhg, custom, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5112","name":"Urinary leg bag","description":"Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","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":"2026-05-10","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":"62163","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1366.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88348","name":"Electron microscopy dx","description":"Electron microscopy, diagnostic","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0766","name":"Elec stim cancer treatment","description":"Electrical stimulation device used for cancer treatment, includes all accessories, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86357","name":"Nk cells total count","description":"Natural killer (nk) cells, total count","date_of_service":"2026-05-10","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":"70310","name":"X-ray exam of teeth","description":"Radiologic examination, teeth; partial examination, less than full mouth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"25251","name":"Removal of wrist prosthesis","description":"Removal of wrist prosthesis; complicated, including total wrist","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":848.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2077.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0154","name":"Walker platform attachment","description":"Platform attachment, walker, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":611.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5711","name":"Knee-shin exo mnl lock ultra","description":"Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"37605","name":"Ligation int/com carotid art","description":"Ligation; internal or common carotid artery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":988.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"75887","name":"Vein x-ray liver w/o hemodyn","description":"Percutaneous transhepatic portography without hemodynamic evaluation, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27355","name":"Remove femur lesion","description":"Excision or curettage of bone cyst or benign tumor of femur;","date_of_service":"2026-05-10","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":"86320","name":"Serum immunoelectrophoresis","description":"Immunoelectrophoresis; serum","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93505","name":"Endomyocardial biopsy","description":"Endomyocardial biopsy","date_of_service":"2026-05-10","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":"L6890","name":"Prefab glove for term device","description":"Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"Q0503","name":"Battery pneum vad replacemnt","description":"Battery for pneumatic ventricular assist device, replacement only, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1396.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":506.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"41135","name":"Tongue and neck surgery","description":"Glossectomy; partial, with unilateral radical neck dissection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0185","name":"Gel pressure mattress pad","description":"Gel or gel-like pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"69105","name":"Biopsy of external ear canal","description":"Biopsy external auditory canal","date_of_service":"2026-05-10","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":"A4376","name":"Drainable rubber pch w fcplt","description":"Ostomy pouch, drainable, with faceplate attached, rubber, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":605.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"64732","name":"Incision of brow nerve","description":"Transection or avulsion of; supraorbital nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6532","name":"Compress stking bk40-50 surg","description":"Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["AW"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":641.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2627","name":"Arm supp att to wc rancho ty","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"46937","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":251.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29240","name":"Strapping of shoulder","description":"Strapping; shoulder (eg, velpeau)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"L6650","name":"Shoulder universal joint","description":"Upper extremity addition, shoulder universal joint, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82747","name":"Assay of folic acid rbc","description":"Folic acid; rbc","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00215","name":"Anes icr px crnop/elvtn fx","description":"Anesthesia for intracranial procedures; cranioplasty or elevation of depressed skull fracture, extradural (simple or compound)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","date_of_service":"2026-05-10","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":"E0291","name":"Hosp bed fx ht w/o rail w/o","description":"Hospital bed, fixed height, without side rails, without mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1013.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":365.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73551","name":"X-ray exam of femur 1","description":"Radiologic examination, femur; 1 view","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":664.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32651","name":"Thoracoscopy remove cortex","description":"Thoracoscopy, surgical; with partial pulmonary decortication","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":987.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"32657","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"50060","name":"Nl removal calculus","description":"Nephrolithotomy; removal of calculus","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"21740","name":"Reconstruction of sternum","description":"Reconstructive repair of pectus excavatum or carinatum; open","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1229.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5530","name":"Prep bk ptb thermopls molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-05-10","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":"E1810","name":"Adjust knee ext & flex dev","description":"Dynamic adjustable knee extension and flexion device, includes soft interface material","date_of_service":"2026-05-10","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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11424","name":"Exc h-f-nk-sp b9+marg 3.1-4","description":"Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 3.1 to 4.0 cm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"95913","name":"Nrv cndj test 13/> studies","description":"Nerve conduction studies; 13 or more studies","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24566","name":"Prq skel fix epcndylr hum fx","description":"Percutaneous skeletal fixation of humeral epicondylar fracture, medial or lateral, with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":604.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5682","name":"Bk thigh lacer glut/ischia m","description":"Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded","date_of_service":"2026-05-10","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":"77782","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1192.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23540","name":"Cltx acromclav dislc wo mnpj","description":"Closed treatment of acromioclavicular dislocation; without manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"17250","name":"Chem caut of granltj tissue","description":"Chemical cauterization of granulation tissue (ie, proud flesh)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":98.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"75810","name":"Vein x-ray spleen/liver","description":"Splenoportography, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3760","name":"Eo adj jt prefab custom fit","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific  patient by an individual with expertise","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":610.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"Q4002","name":"Cast sup body cast fiberglas","description":"Cast supplies, body cast adult, with or without head, fiberglass","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1820","name":"Ko elas w/ condyle pads & jo","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1769.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5991","name":"Low pros ext osseo connector","description":"Addition to lower extremity prostheses, osseointegrated external prosthetic connector","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1183.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1310","name":"Post-operative body jacket","description":"Other scoliosis procedure, post-operative body jacket","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1033.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93529","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"27122","name":"Reconstruction of hip socket","description":"Acetabuloplasty; resection, femoral head (eg, girdlestone procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1303.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73020","name":"X-ray exam of shoulder","description":"Radiologic examination, shoulder; 1 view","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19112","name":"Excise breast duct fistula","description":"Excision of lactiferous duct fistula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30210","name":"Nasal sinus therapy","description":"Displacement therapy (proetz type)","date_of_service":"2026-05-10","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":"69667","name":"Repair middle ear structures","description":"Repair round window fistula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":923.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":681.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95907","name":"Nvr cndj tst 1-2 studies","description":"Nerve conduction studies; 1-2 studies","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0974","name":"Tlso full corset","description":"Tlso, full corset","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"V2318","name":"Lens aniseikonic trifocal","description":"Aniseikonic lens, trifocal","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6529","name":"G com garmt bra night custm","description":"Gradient compression garment, bra, for nighttime use, custom, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"L3350","name":"Shoe heel wedge","description":"Heel wedge","date_of_service":"2026-05-10","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":"58805","name":"Drainage of ovarian cyst(s)","description":"Drainage of ovarian cyst(s), unilateral or bilateral (separate procedure); abdominal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92145","name":"Corneal hysteresis deter","description":"Corneal hysteresis determination, by air impulse stimulation, unilateral or bilateral, with interpretation and report","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"28475","name":"Cltx metatarsal fx w/mnpj ea","description":"Closed treatment of metatarsal fracture; with manipulation, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31820","name":"Closure of windpipe lesion","description":"Surgical closure tracheostomy or fistula; without plastic repair","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"88349","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93668","name":"Peripheral vascular rehab","description":"Peripheral arterial disease (pad) rehabilitation, per session","date_of_service":"2026-05-10","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":"31715","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":561.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["KN"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"77285","name":"Ther rad simulaj field intrm","description":"Therapeutic radiology simulation-aided field setting; intermediate","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"L3485","name":"Shoe heel pad removable for","description":"Heel, pad, removable for spur","date_of_service":"2026-05-10","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":"73092","name":"X-ray exam of arm infant","description":"Radiologic examination; upper extremity, infant, minimum of 2 views","date_of_service":"2026-05-10","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":"52301","name":"Cystoscopy and treatment","description":"Cystourethroscopy; with resection or fulguration of ectopic ureterocele(s), unilateral or bilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":347.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73520","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5699","name":"Shoulder harness","description":"All lower extremity prostheses, shoulder harness","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0682","name":"Non pneum compress full arm","description":"Non-pneumatic sequential compression garment, full arm","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"28294","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24346","name":"Reconstruct elbow med ligmnt","description":"Reconstruction medial collateral ligament, elbow, with tendon graft (includes harvesting of graft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1261.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":722.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":"01220","name":"Anes clsd px upper 2/3 femur","description":"Anesthesia for all closed procedures involving upper two-thirds of femur","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2312","name":"Lens sphc trifo 7.25-12/2.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","date_of_service":"2026-05-10","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":"27269","name":"Optx thigh fx","description":"Open treatment of femoral fracture, proximal end, head, includes internal fixation, when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49900","name":"Repair of abdominal wall","description":"Suture, secondary, of abdominal wall for evisceration or dehiscence","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51575","name":"Removal of bladder & nodes","description":"Cystectomy, complete; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1944.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0210","name":"Electric heat pad standard","description":"Electric heat pad, standard","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64573","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":439.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"A7043","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"L8030","name":"Breast prosthes w/o adhesive","description":"Breast prosthesis, silicone or equal, without integral adhesive","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63741","name":"Install spinal shunt","description":"Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other; percutaneous, not requiring laminectomy","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":595.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"J1180","name":"Dyphylline injection","description":"Injection, dyphylline, up to 500 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2132","name":"Kafo femoral fx cast soft","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26705","name":"Treat knuckle dislocation","description":"Closed treatment of metacarpophalangeal dislocation, single, with manipulation; requiring anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0065","name":"Spoke protectors","description":"Spoke protectors, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"59870","name":"Evacuate mole of uterus","description":"Uterine evacuation and curettage for hydatidiform mole","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0269T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"57720","name":"Revision of cervix","description":"Trachelorrhaphy, plastic repair of uterine cervix, vaginal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":346.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43652","name":"Laparoscopy vagus nerve","description":"Laparoscopy, surgical; transection of vagus nerves, selective or highly selective","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":867.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0956","name":"W/c lateral trunk/hip suppor","description":"Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00142","name":"Anes px on eye lens surgery","description":"Anesthesia for procedures on eye; lens surgery","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7507","name":"Integrated filter & holder","description":"Filter holder and integrated filter without adhesive, for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-10","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":"31576","name":"Laryngoscopy with biopsy","description":"Laryngoscopy, flexible; with biopsy(ies)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53446","name":"Remove uro sphincter","description":"Removal of inflatable urethral/bladder neck sphincter, including pump, reservoir, and cuff","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84035","name":"Assay of phenylketones","description":"Phenylketones, qualitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"44180","name":"Lap enterolysis","description":"Laparoscopy, surgical, enterolysis (freeing of intestinal adhesion) (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67515","name":"Inject/treat eye socket","description":"Injection of medication or other substance into tenons capsule","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"67902","name":"Repair eyelid defect","description":"Repair of blepharoptosis; frontalis muscle technique with autologous fascial sling (includes obtaining fascia)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"27703","name":"Reconstruction ankle joint","description":"Arthroplasty, ankle; revision, total ankle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"89310","name":"Semen analysis w/count","description":"Semen analysis; motility and count (not including huhner test)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"88189","name":"Flowcytometry/read 16 & >","description":"Flow cytometry, interpretation; 16 or more markers","date_of_service":"2026-05-10","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":"00520","name":"Anes closed chest px nos","description":"Anesthesia for closed chest procedures; (including bronchoscopy) not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"44100","name":"Biopsy of bowel","description":"Biopsy of intestine by capsule, tube, peroral (1 or more specimens)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5658","name":"Socket insert above knee","description":"Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43840","name":"Gstrrphy sutr duol/gstr ulcr","description":"Gastrorrhaphy, suture of perforated duodenal or gastric ulcer, wound, or injury","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KC"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0848","name":"Pwc gp 3 std seat/back","description":"Power wheelchair, group 3 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44121","name":"Removal of small intestine","description":"Enterectomy, resection of small intestine; each additional resection and anastomosis (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":201.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":657.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6910","name":"Hand restoration no fingers","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0497T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"44147","name":"Partial removal of colon","description":"Colectomy, partial; abdominal and transanal approach","date_of_service":"2026-05-10","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":"K0807","name":"Pov group 2 hd 301-450 lbs","description":"Power operated vehicle, group 2 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33507","name":"Repair art intramural","description":"Repair of anomalous (eg, intramural) aortic origin of coronary artery by unroofing or translocation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1498.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5707","name":"Custom shape cvr hip disart","description":"Custom shaped protective cover, hip disarticulation","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0168","name":"Heavyduty/wide commode chair","description":"Commode chair, extra wide and/or heavy duty, stationary or mobile, with or without arms, any type, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1734.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"86611","name":"Bartonella antibody","description":"Antibody; bartonella","date_of_service":"2026-05-10","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":"E0200","name":"Heat lamp without stand","description":"Heat lamp, without stand (table model), includes bulb, or infrared element","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L2550","name":"Thigh/wght bear high roll cu","description":"Addition to lower extremity, thigh/weight bearing, high roll cuff","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"92990","name":"Revision of pulmonary valve","description":"Percutaneous balloon valvuloplasty; pulmonary valve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0175","name":"Commode chair foot rest","description":"Foot rest, for use with commode chair, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86325","name":"Other immunoelectrophoresis","description":"Immunoelectrophoresis; other fluids (eg, urine, cerebrospinal fluid) with concentration","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43840","name":"Gstrrphy sutr duol/gstr ulcr","description":"Gastrorrhaphy, suture of perforated duodenal or gastric ulcer, wound, or injury","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1085.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6130","name":"Elbow stump activated lock h","description":"Below elbow, molded double wall split socket, stump activated locking hinge, half cuff","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90678","name":"Rsv vacc pref bivalent im","description":"Respiratory syncytial virus vaccine, pref, subunit, bivalent, for intramuscular use","date_of_service":"2026-05-10","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":363.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53510","name":"Repair of urethra injury","description":"Urethrorrhaphy, suture of urethral wound or injury; perineal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":704.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"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":"2026-05-10","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":"L0622","name":"Sio flex pelvisacral custom","description":"Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"19271","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1794.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":600.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":905.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40530","name":"Partial removal of lip","description":"Resection of lip, more than one-fourth, without reconstruction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"54437","name":"Repair corporeal tear","description":"Repair of traumatic corporeal tear(s)","date_of_service":"2026-05-10","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":"83861","name":"Microfluid analy tears","description":"Microfluidic analysis utilizing an integrated collection and analysis device, tear osmolarity","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35549","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1654.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":521.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":622.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"15845","name":"Skin and muscle repair face","description":"Graft for facial nerve paralysis; regional muscle transfer","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0012","name":"Ltwt portbl power whlchr","description":"Lightweight portable motorized/power wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1012","name":"Ctr mount pwr elev leg rest","description":"Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1006","name":"Scoliosis orth sag/ cor","description":"Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual ","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1584.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6039","name":"Passive custom digit/thumb","description":"Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8512","name":"Gel cap for trach voice pros","description":"Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0603","name":"Repl batt alkaline 1.5 v","description":"Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0439","name":"Stationary liquid 02","description":"Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["QB","RR","QF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1847","name":"Ko dbl upright w/air pre cst","description":"Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","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":"71111","name":"X-ray exam ribs/chest4/> vws","description":"Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67850","name":"Dstrj lesion lid margin <1cm","description":"Destruction of lesion of lid margin (up to 1 cm)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"00218","name":"Anes icr px in sitting pos","description":"Anesthesia for intracranial procedures; procedures in sitting position","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.64,"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":"85280","name":"Clot factor xii hageman","description":"Clotting; factor xii (hageman)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"24140","name":"Partial exc bone humerus","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), humerus","date_of_service":"2026-05-10","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":"28485","name":"Optx metatarsal fx each","description":"Open treatment of metatarsal fracture, includes internal fixation, when performed, each","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"26567","name":"Correct finger deformity","description":"Osteotomy; phalanx of finger, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2463.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"92274","name":"Multifocal erg w/i&r","description":"Electroretinography (erg), with interpretation and report; multifocal (mferg)","date_of_service":"2026-05-10","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":"48548","name":"Fuse pancreas and bowel","description":"Pancreaticojejunostomy, side-to-side anastomosis (puestow-type operation)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1392.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33300","name":"Repair of heart wound","description":"Repair of cardiac wound; without bypass","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"72291","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","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":"58290","name":"Vag hyst complex","description":"Vaginal hysterectomy, for uterus greater than 250 g;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1353.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":340.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6647","name":"Shoulder lock actuator","description":"Upper extremity addition, shoulder lock mechanism, body powered actuator","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4044","name":"Cast sup lng leg splnt ped f","description":"Cast supplies, long leg splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"90853","name":"Group psychotherapy","description":"Group psychotherapy (other than of a multiple-family group)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0484","name":"Non-elec oscillatory pep dvc","description":"Oscillatory positive expiratory pressure device, non-electric, any type, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32036","name":"Thoracostomy w/flap drainage","description":"Thoracostomy; with open flap drainage for empyema","date_of_service":"2026-05-10","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":"86280","name":"Hemagglutination inhibition","description":"Hemagglutination inhibition test (hai)","date_of_service":"2026-05-10","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":"36014","name":"Place catheter in artery","description":"Selective catheter placement, left or right pulmonary artery","date_of_service":"2026-05-10","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":"53020","name":"Incision of urethra","description":"Meatotomy, cutting of meatus (separate procedure); except infant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"23400","name":"Fixation of shoulder blade","description":"Scapulopexy (eg, sprengels deformity or for paralysis)","date_of_service":"2026-05-10","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":"48545","name":"Pancreatorrhaphy","description":"Pancreatorrhaphy for injury","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69802","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1188.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"92612","name":"Endoscopy swallow (fees) vid","description":"Flexible endoscopic evaluation of swallowing by cine or video recording;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":398.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1322.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57160","name":"Insert pessary/other device","description":"Fitting and insertion of pessary or other intravaginal support device","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"G6024","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"40801","name":"Drainage of mouth lesion","description":"Drainage of abscess, cyst, hematoma, vestibule of mouth; complicated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":254.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42281","name":"Insertion palate prosthesis","description":"Insertion of pin-retained palatal prosthesis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":178.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"88300","name":"Surgical path gross","description":"Level i - surgical pathology, gross examination only","date_of_service":"2026-05-10","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":"77750","name":"Infuse radioactive materials","description":"Infusion or instillation of radioelement solution (includes 3-month follow-up care)","date_of_service":"2026-05-10","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":"35641","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1749.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5726","name":"Knee-shin ext jnts fld swg e","description":"Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0601","name":"Repl batt silver oxide 1.5 v","description":"Replacement battery for external infusion pump owned by patient, silver oxide, 1.5 volt, each","date_of_service":"2026-05-10","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":"V2301","name":"Lens sphere trifocal 4.12-7.","description":"Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"56420","name":"I&d bartholins gland abscess","description":"Incision and drainage of bartholins gland abscess","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75557","name":"Cardiac mri for morph","description":"Cardiac magnetic resonance imaging for morphology and function without contrast material;","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":563.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0574","name":"Ultrasonic generator w svneb","description":"Ultrasonic/electronic aerosol generator with small volume nebulizer","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G0117","name":"Glaucoma scrn hgh risk direc","description":"Glaucoma screening for high risk patients furnished by an optometrist or ophthalmologist","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"70130","name":"X-ray exam of mastoids","description":"Radiologic examination, mastoids; complete, minimum of 3 views per side","date_of_service":"2026-05-10","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":"82543","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5666","name":"Below knee cuff suspension","description":"Addition to lower extremity, below knee, cuff suspension","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0585","name":"Nebulizer w/ compressor & he","description":"Nebulizer, with compressor and heater","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"L5647","name":"Below knee suction socket","description":"Addition to lower extremity, below knee suction socket","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"0501T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3027.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0500","name":"Ippb all types","description":"Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source","date_of_service":"2026-05-10","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":"42104","name":"Excision lesion mouth roof","description":"Excision, lesion of palate, uvula; without closure","date_of_service":"2026-05-10","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":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43887","name":"Gstr rstcv px opn rmvl port","description":"Gastric restrictive procedure, open; removal of subcutaneous port component only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":326.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"27075","name":"Resect hip tumor","description":"Radical resection of tumor; wing of ilium, 1 pubic or ischial ramus or symphysis pubis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2697.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A4363","name":"Ostomy clamp, replacement","description":"Ostomy clamp, any type, replacement only, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"62252","name":"Csf shunt reprogram","description":"Reprogramming of programmable cerebrospinal shunt","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20926","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":504.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1484.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0609","name":"Repl electrode for aed","description":"Replacement electrodes for use with automated external defibrillator, garment type only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"29893","name":"Endoscopic plantr fasciotomy","description":"Endoscopic plantar fasciotomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92620","name":"Auditory function 60 min","description":"Evaluation of central auditory function, with report; initial 60 minutes","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57230","name":"Repair of urethral lesion","description":"Plastic repair of urethrocele","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"A4455","name":"Adhesive remover per ounce","description":"Adhesive remover or solvent (for tape, cement or other adhesive), per ounce","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82139","name":"Amino acids quan 6 or more","description":"Amino acids, 6 or more amino acids, quantitative, each specimen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"37180","name":"Revision of circulation","description":"Venous anastomosis, open; splenorenal, proximal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1704.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"30545","name":"Rpr choanal atresia trsnpltn","description":"Repair choanal atresia; transpalatine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"A6233","name":"Hydrogel dressing >48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"21025","name":"Excision of bone lower jaw","description":"Excision of bone (eg, for osteomyelitis or bone abscess); mandible","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32405","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95078","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"72255","name":"Myelography thoracic spine","description":"Myelography, thoracic, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0365","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"17304","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"53265","name":"Treatment of urethra lesion","description":"Excision or fulguration; urethral caruncle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4037","name":"Cast sup shrt leg plaster","description":"Cast supplies, short leg cast, adult (11 years +), plaster","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"86800","name":"Thyroglobulin antibody","description":"Thyroglobulin antibody","date_of_service":"2026-05-10","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":"92550","name":"Tympanometry & reflex thresh","description":"Tympanometry and reflex threshold measurements","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"53025","name":"Incision of urethra","description":"Meatotomy, cutting of meatus (separate procedure); infant","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":580.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27420","name":"Revision of unstable kneecap","description":"Reconstruction of dislocating patella; (eg, hauser type procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":896.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"75564","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28001","name":"Drainage of bursa of foot","description":"Incision and drainage, bursa, foot","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2207","name":"Crutch and cane holder","description":"Wheelchair accessory, crutch and cane holder, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1810","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6690","name":"Frame typ sock interscap-tho","description":"Upper extremity addition, frame type socket, interscapular-thoracic","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0780","name":"Mech amb infusion pump <8hrs","description":"Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J1120","name":"Acetazolamid sodium injectio","description":"Injection, acetazolamide sodium, up to 500 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6604","name":"G com bandge low dn foam flt","description":"Gradient compression bandaging supply, low density flat foam sheet, per 250 square centimeters, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1497.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0800","name":"Pov group 1 std up to 300lbs","description":"Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5950","name":"Endo ak ultra-light material","description":"Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70487","name":"Ct maxillofacial w/dye","description":"Computed tomography, maxillofacial area; with contrast material(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":368.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6382","name":"Postop dsg cast chg elb dis/","description":"Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1820","name":"Ko elas w/ condyle pads & jo","description":"Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4394","name":"Ostomy pouch liq deodorant","description":"Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21275","name":"Revision orbitofacial bones","description":"Secondary revision of orbitocraniofacial reconstruction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"21825","name":"Treat sternum fracture","description":"Open treatment of sternum fracture with or without skeletal fixation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54408","name":"Repair multi-comp penis pros","description":"Repair of component(s) of a multi-component, inflatable penile prosthesis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":640.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42550","name":"Injection for salivary x-ray","description":"Injection procedure for sialography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":74.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":788.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3080","name":"Arch supp att to shoe metata","description":"Foot, arch support, non-removable attached to shoe, metatarsal, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6620","name":"Flexion/extension wrist unit","description":"Upper extremity addition, flexion/extension wrist unit, with or without friction","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58925","name":"Removal of ovarian cyst(s)","description":"Ovarian cystectomy, unilateral or bilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33284","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"73092","name":"X-ray exam of arm infant","description":"Radiologic examination; upper extremity, infant, minimum of 2 views","date_of_service":"2026-05-10","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":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4736.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","KF",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62223","name":"Establish brain cavity shunt","description":"Creation of shunt; ventriculo-peritoneal, -pleural, other terminus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1115.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75940","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00580","name":"Anes heart/lung transplant","description":"Anesthesia for heart transplant or heart/lung transplant","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1147.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2700","name":"Balance lens","description":"Balance lens, per lens","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"64821","name":"Sympathectomy radial artery","description":"Sympathectomy; radial artery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":511.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"67901","name":"Repair eyelid defect","description":"Repair of blepharoptosis; frontalis muscle technique with suture or other material (eg, banked fascia)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":352.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0500","name":"Ippb all types","description":"Ippb machine, all types, with built-in nebulization; manual or automatic valves; internal or external power source","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"73615","name":"Contrast x-ray of ankle","description":"Radiologic examination, ankle, arthrography, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27612","name":"Exploration of ankle joint","description":"Arthrotomy, posterior capsular release, ankle, with or without achilles tendon lengthening","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J9120","name":"Dactinomycin injection","description":"Injection, dactinomycin, 0.5 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"27320","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":574.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0476","name":"Baclofen intrathecal trial","description":"Injection, baclofen, 50 mcg for intrathecal trial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"97016","name":"Vasopneumatic device therapy","description":"Application of a modality to 1 or more areas; vasopneumatic devices","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"42325","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"82127","name":"Amino acid single qual","description":"Amino acids; single, qualitative, each specimen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0110","name":"Crutch forearm pair","description":"Crutches, forearm, includes crutches of various materials, adjustable or fixed, pair, complete with tips and handgrips","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"26776","name":"Pin finger dislocation","description":"Percutaneous skeletal fixation of interphalangeal joint dislocation, single, with manipulation","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L4000","name":"Repl girdle milwaukee orth","description":"Replace girdle for spinal orthosis (ctlso or so)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":582.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24650","name":"Cltx rdl head/nck fx wo mnpj","description":"Closed treatment of radial head or neck fracture; without manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":632.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88275","name":"Cytogenetics 100-300","description":"Molecular cytogenetics; interphase in situ hybridization, analyze 100-300 cells","date_of_service":"2026-05-10","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":"C1874","name":"Stent, coated/cov w/del sys","description":"Stent, coated/covered, with delivery system","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92353","name":"Fit aphakia spectcl multifoc","description":"Fitting of spectacle prosthesis for aphakia; multifocal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1820","name":"Soft interface material","description":"Replacement soft interface material, dynamic adjustable extension/flexion device","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29846","name":"Wrist arthroscopy/surgery","description":"Arthroscopy, wrist, surgical; excision and/or repair of triangular fibrocartilage and/or joint debridement","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4544","name":"Electro nerve stimulator rls","description":"Electrode for external lower extremity nerve stimulator for restless legs syndrome","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"00920","name":"Anes px male genitalia nos","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"92986","name":"Revision of aortic valve","description":"Percutaneous balloon valvuloplasty; aortic valve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1401.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":530.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"24147","name":"Prtl exc bone olecrn process","description":"Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, osteomyelitis), olecranon process","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43460","name":"Pressure treatment esophagus","description":"Esophagogastric tamponade, with balloon (sengstaken type)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"88362","name":"Nerve teasing preparations","description":"Nerve teasing preparations","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0643","name":"Lso sag ctr rigi pos pre ots","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3176.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"98927","name":"Osteopath manj 5-6 regions","description":"Osteopathic manipulative treatment (omt); 5-6 body regions involved","date_of_service":"2026-05-10","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":"62220","name":"Establish brain cavity shunt","description":"Creation of shunt; ventriculo-atrial, -jugular, -auricular","date_of_service":"2026-05-10","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":"73020","name":"X-ray exam of shoulder","description":"Radiologic examination, shoulder; 1 view","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"46608","name":"Anoscopy remove for body","description":"Anoscopy; with removal of foreign body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78206","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6450","name":"Lt compres band >=5in/yd","description":"Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E0246","name":"Transfer tub rail attachment","description":"Transfer tub rail attachment","date_of_service":"2026-05-10","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":"93890","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"99357","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"T4537","name":"Reusable underpad bed size","description":"Incontinence product, protective underpad, reusable, bed size, each","date_of_service":"2026-05-10","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":"25660","name":"Cltx rdcrpl/ntrcrpl dislc 1+","description":"Closed treatment of radiocarpal or intercarpal dislocation, 1 or more bones, with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45350","name":"Sgmdsc w/band ligation","description":"Sigmoidoscopy, flexible; with band ligation(s) (eg, hemorrhoids)","date_of_service":"2026-05-10","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":"51726","name":"Complex cystometrogram","description":"Complex cystometrogram (ie, calibrated electronic equipment);","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85307","name":"Assay activated protein c","description":"Activated protein c (apc) resistance assay","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"92287","name":"Ant sgm img ir flrscn angrph","description":"Anterior segment imaging with interpretation and report; with fluorescein angiography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2353","name":"Octreotide injection, depot","description":"Injection, octreotide, depot form for intramuscular injection, 1 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1503.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"42145","name":"Repair palate pharynx/uvula","description":"Palatopharyngoplasty (eg, uvulopalatopharyngoplasty, uvulopharyngoplasty)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"23106","name":"Arthrotomy strnclav joint","description":"Arthrotomy; sternoclavicular joint, with synovectomy, with or without biopsy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86671","name":"Fungus nes antibody","description":"Antibody; fungus, not elsewhere specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-05-10","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":"E0194","name":"Air fluidized bed","description":"Air fluidized bed","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2669.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7526","name":"Tracheostomy tube collar","description":"Tracheostomy tube collar/holder, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-10","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":"82009","name":"Ketone bodys qual","description":"Ketone body(s) (eg, acetone, acetoacetic acid, beta-hydroxybutyrate); qualitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38720","name":"Removal of lymph nodes neck","description":"Cervical lymphadenectomy (complete)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1079.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95929","name":"C motor evoked lwr limbs","description":"Central motor evoked potential study (transcranial motor stimulation); lower limbs","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":556.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20100","name":"Expl pentrg wound neck","description":"Exploration of penetrating wound (separate procedure); neck","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":701.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":476.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55801","name":"Removal of prostate","description":"Prostatectomy, perineal, subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1169.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5341","name":"Hemipelvectomy canadian sach","description":"Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36823","name":"Insertion of cannula(s)","description":"Insertion of arterial and venous cannula(s) for isolated extracorporeal circulation including regional chemotherapy perfusion to an extremity, with or without hyperthermia, with removal of cannula(s) and repair of arteriotomy and venotomy sites","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1225.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2760","name":"Extension per extension per","description":"Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82128","name":"Amino acids mult qual","description":"Amino acids; multiple, qualitative, each specimen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L8615","name":"Coch implant headset replace","description":"Headset/headpiece for use with cochlear implant device, replacement","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"37615","name":"Ligation major artery neck","description":"Ligation, major artery (eg, post-traumatic, rupture); neck","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":474.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"21497","name":"Interdental wirg oth/thn fx","description":"Interdental wiring, for condition other than fracture","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78215","name":"Lvr&spleen img static only","description":"Liver and spleen imaging; static only","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":397.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":732.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76820","name":"Umbilical artery echo","description":"Doppler velocimetry, fetal; umbilical artery","date_of_service":"2026-05-10","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":"85461","name":"Hemoglobin fetal","description":"Hemoglobin or rbcs, fetal, for fetomaternal hemorrhage; rosette","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"0296T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21451","name":"Cltx mndblr fx w/mnpj","description":"Closed treatment of mandibular fracture; with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":638.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88261","name":"Chromosome analysis 5","description":"Chromosome analysis; count 5 cells, 1 karyotype, with banding","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2374","name":"Hand/chin ctrl std joystick","description":"Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0157","name":"Walker crutch attachment","description":"Crutch attachment, walker, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2367.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":212.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G0279","name":"Tomosynthesis, mammo","description":"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0479","name":"Power module combo vad, rep","description":"Power module for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","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":"L1940","name":"Afo molded to patient plasti","description":"Ankle foot orthosis, plastic or other material, custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","date_of_service":"2026-05-10","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":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-05-10","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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"77290","name":"Ther rad simulaj field cplx","description":"Therapeutic radiology simulation-aided field setting; complex","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":334.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4436","name":"Irr supply sleev reus per mo","description":"Irrigation supply; sleeve, reusable, per month","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4239","name":"Non-adju cgm supply allow","description":"Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0736","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50205","name":"Renal bx surg exposure kdn","description":"Renal biopsy; by surgical exposure of kidney","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2500","name":"Contact lens pmma spherical","description":"Contact lens, pmma, spherical, per lens","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2397","name":"Suspension sleeve lower ext","description":"Addition to lower extremity orthosis, suspension sleeve","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1008.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64790","name":"Removal of nerve lesion","description":"Excision of neurofibroma or neurolemmoma; major peripheral nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"44603","name":"Suture small intestine","description":"Suture of small intestine (enterorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture; multiple perforations","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"25000","name":"Incision of tendon sheath","description":"Incision, extensor tendon sheath, wrist (eg, de quervains disease)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0271","name":"Mattress innerspring","description":"Mattress, innerspring","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0808","name":"Pov group 2 vhd 451-600 lbs","description":"Power operated vehicle, group 2 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92573","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1752.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2626","name":"Seo mobile arm sup att to wc","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2190","name":"Waist belt","description":"Addition to lower extremity fracture orthosis, waist belt","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"25931","name":"Amputation follow-up surgery","description":"Transmetacarpal amputation; re-amputation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":940.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":961.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84485","name":"Assay duodenal fluid trypsin","description":"Trypsin; duodenal fluid","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22520","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":564.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"A4230","name":"Infus insulin pump non needl","description":"Infusion set for external insulin pump, non needle cannula type","date_of_service":"2026-05-10","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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2600","name":"Hip clevis/thrust bearing fr","description":"Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"A6252","name":"Absorpt drg >16 <=48 w/o bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"A6215","name":"Foam dressing wound filler","description":"Foam dressing, wound filler, sterile, per gram","date_of_service":"2026-05-10","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":"78586","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"65755","name":"Corneal transplant","description":"Keratoplasty (corneal transplant); penetrating (in pseudophakia)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1217.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"55120","name":"Removal of scrotum lesion","description":"Removal of foreign body in scrotum","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"82261","name":"Assay of biotinidase","description":"Biotinidase, each specimen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"65205","name":"Remove foreign body from eye","description":"Removal of foreign body, external eye; conjunctival superficial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"96111","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86727","name":"Lymph choriomeningitis ab","description":"Antibody; lymphocytic choriomeningitis","date_of_service":"2026-05-10","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":"90801","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33418","name":"Repair tcat mitral valve","description":"Transcatheter mitral valve repair, percutaneous approach, including transseptal puncture when performed; initial prosthesis","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0332","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"76010","name":"X-ray nose to rectum","description":"Radiologic examination from nose to rectum for foreign body, single view, child","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27284","name":"Arthrodesis hip joint","description":"Arthrodesis, hip joint (including obtaining graft);","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1368.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3761","name":"Eo, adj lock joint prefab ot","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"25560","name":"Cltx rdl&uln shft fx wo mnpj","description":"Closed treatment of radial and ulnar shaft fractures; without manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82465","name":"Assay bld/serum cholesterol","description":"Cholesterol, serum or whole blood, total","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76516","name":"Echo exam of eye","description":"Ophthalmic biometry by ultrasound echography, a-scan;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78226","name":"Hepatobiliary system imaging","description":"Hepatobiliary system imaging, including gallbladder when present;","date_of_service":"2026-05-10","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":"L5530","name":"Prep bk ptb thermopls molded","description":"Preparatory, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"38542","name":"Explore deep node(s) neck","description":"Dissection, deep jugular node(s)","date_of_service":"2026-05-10","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":"L3970","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"A4431","name":"Ost pch urine w barrier/tapv","description":"Ostomy pouch, urinary; with barrier attached, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-10","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":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4450","name":"Non-waterproof tape","description":"Tape, non-waterproof, per 18 square inches","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":488.46,"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":"A5054","name":"Clsd ostomy pouch w/flange","description":"Ostomy pouch, closed; for use on barrier with flange (2 piece), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"33764","name":"Shunt central w/prostc graft","description":"Shunt; central, with prosthetic graft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1565.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"21620","name":"Ostectomy sternum partial","description":"Ostectomy of sternum, partial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":623.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"50040","name":"Nfros nfrot w/drg","description":"Nephrostomy, nephrotomy with drainage","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2603","name":"Skin protect wc cus wd <22in","description":"Skin protection wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0890","name":"Traction frame attach pelvic","description":"Traction frame, attached to footboard, pelvic traction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1120","name":"Covers for upright each","description":"Addition to ctlso, scoliosis orthosis, cover for upright, each","date_of_service":"2026-05-10","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":"90633","name":"Hepa vacc ped/adol 2 dose im","description":"Hepatitis a vaccine (hepa), pediatric/adolescent dosage-2 dose schedule, for intramuscular use","date_of_service":"2026-05-10","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":45.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"33755","name":"Shunt as-aort to pulm art","description":"Shunt; ascending aorta to pulmonary artery (waterston type operation)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74455","name":"X-ray urethra/bladder","description":"Urethrocystography, voiding, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"A4928","name":"Surgical mask","description":"Surgical mask, per 20","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L4631","name":"Afo, walk boot type, cus fab","description":"Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7180","name":"Electronic elbow sequential","description":"Electronic elbow, microprocessor sequential control of elbow and terminal device","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1050.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93315","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"26525","name":"Release finger contracture","description":"Capsulectomy or capsulotomy; interphalangeal joint, each joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":938.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":675.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2506","name":"Sgd prerec msg > 40 min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 40 minutes recording time","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1002.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1354.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27250","name":"Treat hip dislocation","description":"Closed treatment of hip dislocation, traumatic; without anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"59414","name":"Deliver placenta","description":"Delivery of placenta (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72240","name":"Myelography neck spine","description":"Myelography, cervical, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5600","name":"Hip disart sach laminat mold","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model","date_of_service":"2026-05-10","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":"23491","name":"Reinforce shoulder bones","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; proximal humerus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":859.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1812","name":"Knee ext/flex w act res ctrl","description":"Dynamic knee, extension/flexion device with active resistance control","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8616","name":"Coch implant microphone repl","description":"Microphone for use with cochlear implant device, replacement","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"51741","name":"Electro-uroflowmetry first","description":"Complex uroflowmetry (eg, calibrated electronic equipment)","date_of_service":"2026-05-10","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":"88381","name":"Microdissection manual","description":"Microdissection (ie, sample preparation of microscopically identified target); manual","date_of_service":"2026-05-10","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":"A4490","name":"Above knee surgical stocking","description":"Surgical stockings above knee length, each","date_of_service":"2026-05-10","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":"A9536","name":"Tc99m depreotide","description":"Technetium tc-99m depreotide, diagnostic, per study dose, up to 35 millicuries","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"33234","name":"Removal of pacemaker system","description":"Removal of transvenous pacemaker electrode(s); single lead system, atrial or ventricular","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":588.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0492","name":"Tlso 3 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in th","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"69840","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74150","name":"Ct abdomen w/o contrast","description":"Computed tomography, abdomen; without contrast material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":361.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3110","name":"Teriparatide injection","description":"Injection, teriparatide, 10 mcg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1040.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2325","name":"Nesiritide injection","description":"Injection, nesiritide, 0.1 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":364.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1077.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84583","name":"Assay of urine urobilinogen","description":"Urobilinogen, urine; semiquantitative","date_of_service":"2026-05-10","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":"36455","name":"Bld exchange truj oth thn nb","description":"Exchange transfusion, blood; other than newborn","date_of_service":"2026-05-10","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":"75805","name":"Lymph vessel x-ray trunk","description":"Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0153","name":"Forearm crutch platform atta","description":"Platform attachment, forearm crutch, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":983.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1024.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74360","name":"X-ray guide gi dilation","description":"Intraluminal dilation of strictures and/or obstructions (eg, esophagus), radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57111","name":"Vagnc compl rmvl paravag tis","description":"Vaginectomy, complete removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"69420","name":"Incision of eardrum","description":"Myringotomy including aspiration and/or eustachian tube inflation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":132.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2734.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0043","name":"Ftrst lowr exten tube rep ea","description":"Footrest, lower extension tube, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2354","name":"Octreotide inj, non-depot","description":"Injection, octreotide, non-depot form for subcutaneous or intravenous injection, 25 mcg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2809.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27025","name":"Fasciotomy hip/thigh any typ","description":"Fasciotomy, hip or thigh, any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":777.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0434","name":"Portable liquid 02","description":"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"G0419","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1131.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"44145","name":"Partial removal of colon","description":"Colectomy, partial; with coloproctostomy (low pelvic anastomosis)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1797.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83915","name":"Assay of nucleotidase","description":"Nucleotidase 5-","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00210","name":"Anes intracranial px nos","description":"Anesthesia for intracranial procedures; not otherwise specified","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":774.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":862.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"76932","name":"Echo guide for heart biopsy","description":"Ultrasonic guidance for endomyocardial biopsy, imaging supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77055","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L0130","name":"Flex thermoplastic collar mo","description":"Cervical, flexible, thermoplastic collar, molded to patient","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"L5645","name":"Bk flex inner socket ext fra","description":"Addition to lower extremity, below knee, flexible inner socket, external frame","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00102","name":"Anes px plstc rpr cleft lip","description":"Anesthesia for procedures involving plastic repair of cleft lip","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35587","name":"Vein byp pop-tibl peroneal","description":"In-situ vein bypass; popliteal-tibial, peroneal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1776.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5570","name":"Prep ak ischial direct form","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1135.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01999","name":"Unlisted anes procedure","description":"Unlisted anesthesia procedure(s)","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":"52320","name":"Cystoscopy and treatment","description":"Cystourethroscopy (including ureteral catheterization); with removal of ureteral calculus","date_of_service":"2026-05-10","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":"78458","name":"Ven thrombosis images bilat","description":"Venous thrombosis imaging, venogram; bilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84540","name":"Assay of urine/urea-n","description":"Urea nitrogen, urine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"29505","name":"Application long leg splint","description":"Application of long leg splint (thigh to ankle or toes)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":222.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":232.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A8001","name":"Hard protect helmet prefab","description":"Helmet, protective, hard, prefabricated, includes all components and accessories","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0820","name":"Halo cervical into body jack","description":"Halo procedure, cervical halo incorporated into plaster body jacket","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":229.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2059.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75600","name":"Contrast exam thoracic aorta","description":"Aortography, thoracic, without serialography, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":678.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4428","name":"Urine ost pouch w faucet/tap","description":"Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each","date_of_service":"2026-05-10","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":"39200","name":"Resect mediastinal cyst","description":"Resection of mediastinal cyst","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":339.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0480","name":"Tlso rigid plastic custom fa","description":"Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, res","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"85385","name":"Fibrinogen antigen","description":"Fibrinogen; antigen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"26130","name":"Remove wrist joint lining","description":"Synovectomy, carpometacarpal joint","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2631","name":"Elevat proximal arm support","description":"Wheelchair accessory, addition to mobile arm support, elevating proximal arm","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4417","name":"Ost pch w bar/bltinconv/fltr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity, with filter (1 piece), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"72020","name":"X-ray exam of spine 1 view","description":"Radiologic examination, spine, single view, specify level","date_of_service":"2026-05-10","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":"78110","name":"Plasma volume single","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38780","name":"Remove abdomen lymph nodes","description":"Retroperitoneal transabdominal lymphadenectomy, extensive, including pelvic, aortic, and renal nodes (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1185.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"40500","name":"Partial excision of lip","description":"Vermilionectomy (lip shave), with mucosal advancement","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":405.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8512","name":"Gel cap for trach voice pros","description":"Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1674.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"23491","name":"Reinforce shoulder bones","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; proximal humerus","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8658","name":"Interphalangeal joint spacer","description":"Interphalangeal joint spacer, silicone or equal, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01120","name":"Anes px on bony pelvis","description":"Anesthesia for procedures on bony pelvis","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"J9151","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27614","name":"Biopsy lower leg soft tissue","description":"Biopsy, soft tissue of leg or ankle area; deep (subfascial or intramuscular)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":94.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38212","name":"Rbc depletion of harvest","description":"Transplant preparation of hematopoietic progenitor cells; red blood cell removal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62318","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"48500","name":"Surgery of pancreatic cyst","description":"Marsupialization of pancreatic cyst","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1099.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69552","name":"Exc aurl glomus tum trnsmstd","description":"Excision aural glomus tumor; transmastoid","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78456","name":"Acute venous thrombus image","description":"Acute venous thrombosis imaging, peptide","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78202","name":"Liver imaging with vasc flow","description":"Liver imaging; with vascular flow","date_of_service":"2026-05-10","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":"49605","name":"Repair umbilical lesion","description":"Repair of large omphalocele or gastroschisis; with or without prosthesis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4188.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1221","name":"Wheelchair spec size w foot","description":"Wheelchair with fixed arm, footrests","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":739.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"00820","name":"Anes px lwr post abdl wall","description":"Anesthesia for procedures on lower posterior abdominal wall","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"G6018","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"95965","name":"Meg spontaneous","description":"Magnetoencephalography (meg), recording and analysis; for spontaneous brain magnetic activity (eg, epileptic cerebral cortex localization)","date_of_service":"2026-05-10","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":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51030","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00214","name":"Anes icr px burr holes","description":"Anesthesia for intracranial procedures; burr holes, including ventriculography","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":228.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0394","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6630","name":"Stainless steel any wrist","description":"Upper extremity addition, stainless steel, any wrist","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1950","name":"Afo spiral molded to pt plas","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":462.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73201","name":"Ct upper extremity w/dye","description":"Computed tomography, upper extremity; with contrast material(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0434","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"87166","name":"Dark field exam w/o collj","description":"Dark field examination, any source (eg, penile, vaginal, oral, skin); without collection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"00950","name":"Anes vag px culdoscopy","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); culdoscopy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11040","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35341","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; mesenteric, celiac, or renal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1779.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0202","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15841","name":"Nerve palsy muscle graft","description":"Graft for facial nerve paralysis; free muscle graft (including obtaining graft)","date_of_service":"2026-05-10","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":"82307","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6703","name":"Term dev, passive hand mitt","description":"Terminal device, passive hand/mitt, any material, any size","date_of_service":"2026-05-10","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":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1028.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1392","name":"Portable oxygen concentrator","description":"Portable oxygen concentrator, rental","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["QB","RR","QF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"52606","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1138.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1051","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":754.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","QW","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85810","name":"Blood viscosity examination","description":"Viscosity","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"33417","name":"Repair of aortic valve","description":"Aortoplasty (gusset) for supravalvular stenosis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2071.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":391.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1004","name":"Pwr seat recline mech","description":"Wheelchair accessory, power seating system, recline only, with mechanical shear reduction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L6697","name":"Cus elbo skt in not con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":641.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5930","name":"High activity knee frame","description":"Addition, endoskeletal system, high activity knee control frame","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2238.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0003","name":"Lightweight wheelchair","description":"Lightweight wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0295","name":"Hosp bed semi-elect w/o matt","description":"Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"92612","name":"Endoscopy swallow (fees) vid","description":"Flexible endoscopic evaluation of swallowing by cine or video recording;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"38530","name":"Biopsy/removal lymph nodes","description":"Biopsy or excision of lymph node(s); open, internal mammary node(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"10120","name":"Inc&rmvl fb subq tiss smpl","description":"Incision and removal of foreign body, subcutaneous tissues; simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72202","name":"X-ray exam si joints 3/> vws","description":"Radiologic examination, sacroiliac joints; 3 or more views","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2327","name":"Head control interface mech","description":"Power wheelchair accessory, head control interface, mechanical, proportional, including all related electronics, mechanical direction change switch, and fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"54530","name":"Removal of testis","description":"Orchiectomy, radical, for tumor; inguinal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00170","name":"Anes intraoral px nos","description":"Anesthesia for intraoral procedures, including biopsy; not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"0172T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"93530","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8622","name":"Repl alkaline battery","description":"Alkaline battery for use with cochlear implant device, any size, replacement, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"15420","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3450","name":"Shoe heel sach cushion type","description":"Heel, sach cushion type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"62116","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90847","name":"Family psytx w/pt 50 min","description":"Family psychotherapy (conjoint psychotherapy) (with patient present), 50 minutes","date_of_service":"2026-05-10","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":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0838","name":"Pwc gp 2 hd sing pow opt cap","description":"Power wheelchair, group 2 heavy duty, single power option, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":"51702","name":"Insert temp bladder cath","description":"Insertion of temporary indwelling bladder catheter; simple (eg, foley)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":217.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":929.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87003","name":"Small animal inoculation","description":"Animal inoculation, small animal, with observation and dissection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"92596","name":"Ear protector evaluation","description":"Ear protector attenuation measurements","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"D1206","name":"Topical fluoride varnish","description":"Topical fluoride varnish; therapeutic application for moderate to high caries risk patients","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"00103","name":"Anes rcnstv px eyelid","description":"Anesthesia for reconstructive procedures of eyelid (eg, blepharoplasty, ptosis surgery)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1203.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90849","name":"Multiple family group psytx","description":"Multiple-family group psychotherapy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4392","name":"Urinary pouch w st wear barr","description":"Ostomy pouch, urinary, with standard wear barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0316","name":"Bed safety enclosure","description":"Safety enclosure frame/canopy for use with hospital bed, any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0279","name":"Tomosynthesis, mammo","description":"Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72125","name":"Ct neck spine w/o dye","description":"Computed tomography, cervical spine; without contrast material","date_of_service":"2026-05-10","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":"A6231","name":"Hydrogel dsg<=16 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":646.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"25443","name":"Arthrp prostc dstl scph crpl","description":"Arthroplasty with prosthetic replacement; scaphoid carpal (navicular)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"01650","name":"Anes art sho&ax nos","description":"Anesthesia for procedures on arteries of shoulder and axilla; not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":476.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15321","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":102.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"73542","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"77076","name":"Radex osseous survey infant","description":"Radiologic examination, osseous survey, infant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00830","name":"Anes hernia rpr lwr abd nos","description":"Anesthesia for hernia repairs in lower abdomen; not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1592.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":764.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86320","name":"Serum immunoelectrophoresis","description":"Immunoelectrophoresis; serum","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86334","name":"Immunofix e-phoresis serum","description":"Immunofixation electrophoresis; serum","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"25240","name":"Partial removal of ulna","description":"Excision distal ulna partial or complete (eg, darrach type or matched resection)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":824.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86353","name":"Lymphocyte transformation","description":"Lymphocyte transformation, mitogen (phytomitogen) or antigen induced blastogenesis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0141","name":"Rigid wheeled walker adj/fix","description":"Walker, rigid, wheeled, adjustable or fixed height","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L8689","name":"External recharg sys intern","description":"External recharging system for battery (internal) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":840.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6022","name":"Collagen drsg>16<=48 sq in","description":"Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":302.38,"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":"50845","name":"Appendico-vesicostomy","description":"Cutaneous appendico-vesicostomy","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"51703","name":"Insert bladder cath complex","description":"Insertion of temporary indwelling bladder catheter; complicated (eg, altered anatomy, fractured catheter/balloon)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2196.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":817.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00635","name":"Anes dx/ther lumbar pnxr","description":"Anesthesia for procedures in lumbar region; diagnostic or therapeutic lumbar puncture","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"0064A","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94375","name":"Respiratory flow volume loop","description":"Respiratory flow volume loop","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27385","name":"Repair of thigh muscle","description":"Suture of quadriceps or hamstring muscle rupture; primary","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":768.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8629","name":"Cid transmit coil and cable","description":"Transmitting coil and cable, integrated, for use with cochlear implant device, replacement","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3264.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84228","name":"Assay of quinine","description":"Quinine","date_of_service":"2026-05-10","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":"01260","name":"Anes all px veins upper leg","description":"Anesthesia for all procedures involving veins of upper leg, including exploration","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"46716","name":"Rep perf anoper/vestib fistu","description":"Repair of low imperforate anus; with transposition of anoperineal or anovestibular fistula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"L2040","name":"Hkafo torsion bil rot straps","description":"Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6610","name":"Flexible metal hinge pair","description":"Upper extremity additions, flexible metal hinge, pair","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"35612","name":"Bpg subclavian-subclavian","description":"Bypass graft, with other than vein; subclavian-subclavian","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1147.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0930","name":"Fracture frame free standing","description":"Fracture frame, free standing, includes weights","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25810","name":"Arthrd wrst iliac/oth agrft","description":"Arthrodesis, wrist; with iliac or other autograft (includes obtaining graft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":725.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95913","name":"Nrv cndj test 13/> studies","description":"Nerve conduction studies; 13 or more studies","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28113","name":"Part removal of metatarsal","description":"Ostectomy, complete excision; fifth metatarsal head","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1412.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76380","name":"Cat scan follow-up study","description":"Computed tomography, limited or localized follow-up study","date_of_service":"2026-05-10","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":"J0470","name":"Dimecaprol injection","description":"Injection, dimercaprol, per 100 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-10","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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0117","name":"Underarm springassist crutch","description":"Crutch, underarm, articulating, spring assisted, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1221","name":"Wheelchair spec size w foot","description":"Wheelchair with fixed arm, footrests","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49653","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"94260","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"L6707","name":"Term dev mech hook vol close","description":"Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2383.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0565","name":"Compressor air power source","description":"Compressor, air power source for equipment which is not self-contained or cylinder driven","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75961","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"86225","name":"Dna antibody native","description":"Deoxyribonucleic acid (dna) antibody; native or double stranded","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"CPT","billing_code_type_version":"2026","billing_code":"82965","name":"Assay of gdh enzyme","description":"Glutamate dehydrogenase","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"87492","name":"Chlmyd trach dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia trachomatis, quantification","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6214","name":"Foam drg > 48 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":175.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0206","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"L8688","name":"Implt nrostm pls gen dua non","description":"Implantable neurostimulator pulse generator, dual array, non-rechargeable, includes extension","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3480","name":"Shoe heel pad & depress for","description":"Heel, pad and depression for spur","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":"32215","name":"Treat chest lining","description":"Pleural scarification for repeat pneumothorax","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":633.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43831","name":"Gastrostomy open neonatal","description":"Gastrostomy, open; neonatal, for feeding","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":597.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1325.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KN"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":133.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0491","name":"Emr pwr source combo vad rep","description":"Emergency power source for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","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":"77074","name":"Radex osseous survey lmtd","description":"Radiologic examination, osseous survey; limited (eg, for metastases)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"74241","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6253","name":"Absorpt drg > 48 sq in w/o b","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L6935","name":"Below elbow myoelectronic ct","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3894.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":118.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65275","name":"Repair of eye wound","description":"Repair of laceration; cornea, nonperforating, with or without removal foreign body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L4370","name":"Pneum full leg splnt pre ots","description":"Pneumatic full leg splint, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-10","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":"24800","name":"Arthrodesis elbw joint local","description":"Arthrodesis, elbow joint; local","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":978.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1300.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2361","name":"22nf sealed leadacid battery","description":"Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":"92953","name":"Temporary external pacing","description":"Temporary transcutaneous pacing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54530","name":"Removal of testis","description":"Orchiectomy, radical, for tumor; inguinal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0749","name":"Elec osteogen stim implanted","description":"Osteogenesis stimulator, electrical, surgically implanted","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"27307","name":"Incision of thigh tendons","description":"Tenotomy, percutaneous, adductor or hamstring; multiple tendons","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":560.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.16,"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":"49423","name":"Exchange drainage catheter","description":"Exchange of previously placed abscess or cyst drainage catheter under radiological guidance (separate procedure)","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"67700","name":"Blepharotomy drg absc eyelid","description":"Blepharotomy, drainage of abscess, eyelid","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"55100","name":"Drainage of scrotum abscess","description":"Drainage of scrotal wall abscess","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"42650","name":"Dilation of salivary duct","description":"Dilation salivary duct","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"54600","name":"Reduce testis torsion","description":"Reduction of torsion of testis, surgical, with or without fixation of contralateral testis","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"42800","name":"Biopsy of throat","description":"Biopsy; oropharynx","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2159.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":276.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2405","name":"Ondansetron hcl injection","description":"Injection, ondansetron hydrochloride, per 1 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"33737","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00622","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"87152","name":"Culture type pulse field gel","description":"Culture, typing; identification by pulse field gel typing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"73565","name":"X-ray exam of knees","description":"Radiologic examination, knee; both knees, standing, anteroposterior","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"24330","name":"Flexor-plasty elbow","description":"Flexor-plasty, elbow (eg, steindler type advancement);","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":870.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00950","name":"Anes vag px culdoscopy","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); culdoscopy","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3925","name":"Fo pip dip jnt/sprng pre ots","description":"Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"67227","name":"Dstrj extensive retinopathy","description":"Destruction of extensive or progressive retinopathy (eg, diabetic retinopathy), cryotherapy, diathermy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":551.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66770","name":"Removal of inner eye lesion","description":"Destruction of cyst or lesion iris or ciliary body (nonexcisional procedure)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":475.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":127.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1043.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49590","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":613.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"K0856","name":"Pwc gp3 std sing pow opt s/b","description":"Power wheelchair, group 3 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":282.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"50395","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0986","name":"Man w/c powr assist syst","description":"Manual wheelchair accessory, power assist system","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00912","name":"Anes trurl px rescj bldr tum","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of bladder tumor(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31586","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":887.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0650","name":"Lso sc r ant/pos pnl pre ots","description":"Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, inclu","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1894.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5611","name":"Ak 4 bar link w/fric swing","description":"Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control","date_of_service":"2026-05-10","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":"33676","name":"Close mult vsd w/resection","description":"Closure of multiple ventricular septal defects; with pulmonary valvotomy or infundibular resection (acyanotic)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1760.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80178","name":"Assay of lithium","description":"Lithium","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"L5060","name":"Symes met fr leath socket ar","description":"Ankle, symes, metal frame, molded leather socket, articulated ankle/foot","date_of_service":"2026-05-10","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":"E1015","name":"Shock absorber for man w/c","description":"Shock absorber for manual wheelchair, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2907.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74475","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1285.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":344.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2385.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70332","name":"X-ray exam of jaw joint","description":"Temporomandibular joint arthrography, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"G6002","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8046","name":"Partial facial prosthesis","description":"Partial facial prosthesis, provided by a non-physician","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76604","name":"Us exam chest","description":"Ultrasound, chest (includes mediastinum), real time with image documentation","date_of_service":"2026-05-10","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":"64788","name":"Remove skin nerve lesion","description":"Excision of neurofibroma or neurolemmoma; cutaneous nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":396.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4389","name":"Drainable pch w st wear barr","description":"Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2308","name":"Lens sphc trifocal 4.25-7/2.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-10","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":"01654","name":"Anes art sho&ax bypass grf","description":"Anesthesia for procedures on arteries of shoulder and axilla; bypass graft","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1258.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78806","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"84481","name":"Free assay (ft-3)","description":"Triiodothyronine t3; free","date_of_service":"2026-05-10","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":"35531","name":"Art byp grft aorcel/aormesen","description":"Bypass graft, with vein; aortoceliac or aortomesenteric","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3808","name":"Whfo, rigid w/o joints","description":"Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"28630","name":"Treat toe dislocation","description":"Closed treatment of metatarsophalangeal joint dislocation; without anesthesia","date_of_service":"2026-05-10","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":"33471","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0045","name":"Ftrst compl assembly repl ea","description":"Footrest, complete assembly, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0880","name":"Trac stand free stand extrem","description":"Traction stand, free standing, extremity traction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":858.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":151.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3209","name":"Surgical boot each child","description":"Surgical boot, each, child","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82759","name":"Assay of rbc galactokinase","description":"Galactokinase, rbc","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93727","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27730","name":"Repair of tibia epiphysis","description":"Arrest, epiphyseal (epiphysiodesis), open; distal tibia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28430","name":"Cltx talus fracture w/o mnpj","description":"Closed treatment of talus fracture; without manipulation","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6442","name":"Conform band n/s w<3in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73615","name":"Contrast x-ray of ankle","description":"Radiologic examination, ankle, arthrography, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"43450","name":"Dilate esophagus 1/mult pass","description":"Dilation of esophagus, by unguided sound or bougie, single or multiple passes","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15000","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":725.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"67311","name":"Revise eye muscle","description":"Strabismus surgery, recession or resection procedure; 1 horizontal muscle","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":487.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":317.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2231","name":"Solid seat support base","description":"Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":955.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31395","name":"Reconstruct larynx & pharynx","description":"Pharyngolaryngectomy, with radical neck dissection; with reconstruction","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0842","name":"Pwc gp2 std mult pow opt cap","description":"Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"61860","name":"Implant neuroelectrodes","description":"Craniectomy or craniotomy for implantation of neurostimulator electrodes, cerebral, cortical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83505","name":"Assay total hydroxyproline","description":"Hydroxyproline; total","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":966.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21320","name":"Clsd tx nsl fx w/mnpj&stablj","description":"Closed treatment of nasal bone fracture with manipulation; with stabilization","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5629","name":"Below knee acrylic socket","description":"Addition to lower extremity, below knee, acrylic socket","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":210.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63287","name":"Bx/exc idrl imed lesn thrlmb","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, thoracolumbar","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2526.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6236","name":"Hydrocolld drg > 48 in w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","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":"A7038","name":"Pos airway pressure filter","description":"Filter, disposable, used with positive airway pressure device","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00124","name":"Anes px ear otoscopy","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; otoscopy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"64809","name":"Sympathectomy thoracolumbar","description":"Sympathectomy, thoracolumbar","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":926.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-10","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":"0044A","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"32900","name":"Removal of rib(s)","description":"Resection of ribs, extrapleural, all stages","date_of_service":"2026-05-10","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":"L6687","name":"Frame typ socket bel elbow/w","description":"Upper extremity addition, frame type socket, below elbow or wrist disarticulation","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42836","name":"Removal of adenoids","description":"Adenoidectomy, secondary; age 12 or over","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4672","name":"Drainage ext line, dialysis","description":"Drainage extension line, sterile, for dialysis, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1037","name":"Transport chair, ped size","description":"Transport chair, pediatric size","date_of_service":"2026-05-10","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":"35741","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":432.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86336","name":"Inhibin a","description":"Inhibin a","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77014","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-10","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":"26100","name":"Biopsy hand joint lining","description":"Arthrotomy with biopsy; carpometacarpal joint, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":411.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26412","name":"Repair/graft hand tendon","description":"Repair, extensor tendon, hand, primary or secondary; with free graft (includes obtaining graft), each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29860","name":"Hip arthroscopy dx","description":"Arthroscopy, hip, diagnostic with or without synovial biopsy (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":747.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"43124","name":"Removal of esophagus","description":"Total or partial esophagectomy, without reconstruction (any approach), with cervical esophagostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1971.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","date_of_service":"2026-05-10","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":"88230","name":"Tissue culture lymphocyte","description":"Tissue culture for non-neoplastic disorders; lymphocyte","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"22521","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":662.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75964","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1848.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"J2260","name":"Inj milrinone lactate / 5 mg","description":"Injection, milrinone lactate, 5 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":459.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2340","name":"W/c wdth 20-23 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame width, 20-23 inches","date_of_service":"2026-05-10","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":"L3030","name":"Foot arch support remov prem","description":"Foot, insert, removable, formed to patient foot, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61708","name":"Revise circulation to head","description":"Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intracranial electrothrombosis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2311.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1959.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1060.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77305","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"K0821","name":"Pwc gp 2 std port cap chair","description":"Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4736.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-10","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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"E0669","name":"Seg pneumatic appli half leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"58285","name":"Extensive hysterectomy","description":"Vaginal hysterectomy, radical (schauta type operation)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":895.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2521","name":"Cntct lens hydrophilic toric","description":"Contact lens, hydrophilic, toric, or prism ballast, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"K0073","name":"Caster pin lock each","description":"Caster pin lock, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"45005","name":"Drainage of rectal abscess","description":"Incision and drainage of submucosal abscess, rectum","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76831","name":"Echo exam uterus","description":"Saline infusion sonohysterography (sis), including color flow doppler, when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1058.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1681","name":"Ho bilateral hip abduction","description":"Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":512.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62223","name":"Establish brain cavity shunt","description":"Creation of shunt; ventriculo-peritoneal, -pleural, other terminus","date_of_service":"2026-05-10","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":"E0100","name":"Cane adjust/fixed with tip","description":"Cane, includes canes of all materials, adjustable or fixed, with tip","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"L6582","name":"Wrist/elbow bowden cbl dir f","description":"Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0601","name":"Cont airway pressure device","description":"Continuous positive airway pressure (cpap) device","date_of_service":"2026-05-10","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":"72265","name":"Myelography l-s spine","description":"Myelography, lumbosacral, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74010","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"75710","name":"Artery x-rays arm/leg","description":"Angiography, extremity, unilateral, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"93602","name":"Intra-atrial recording","description":"Intra-atrial recording","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00144","name":"Anes px eye corneal trnspl","description":"Anesthesia for procedures on eye; corneal transplant","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84244","name":"Assay of renin","description":"Renin","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"G6015","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64680","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent, with or without radiologic monitoring; celiac plexus","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01990","name":"Physiol support hrvg organs","description":"Physiological support for harvesting of organ(s) from brain-dead patient","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0044","name":"Ftrst upr hanger brac rep ea","description":"Footrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","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":"82030","name":"Assay of adp & amp","description":"Adenosine, 5-monophosphate, cyclic (cyclic amp)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"96420","name":"Chemo ia push tecnique","description":"Chemotherapy administration, intra-arterial; push technique","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83883","name":"Assay nephelometry not spec","description":"Nephelometry, each analyte not elsewhere specified","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"29582","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"80160","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"L2350","name":"Prosthetic type socket molde","description":"Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for ptb afo orthoses)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"31256","name":"Exploration maxillary sinus","description":"Nasal/sinus endoscopy, surgical, with maxillary antrostomy;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"93890","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3225","name":"Mans shoe oxford brace","description":"Orthopedic footwear, mans shoe, oxford, used as an integral part of a brace (orthosis)","date_of_service":"2026-05-10","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":"78075","name":"Adrenal cortex & medulla img","description":"Adrenal imaging, cortex and/or medulla","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2118","name":"Lens aniseikonic single","description":"Aniseikonic lens, single vision","date_of_service":"2026-05-10","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":"45390","name":"Colonoscopy w/resection","description":"Colonoscopy, flexible; with endoscopic mucosal resection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2210","name":"Dorsiflexion assist each joi","description":"Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00952","name":"Anes vag px hystsc&/hsg","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); hysteroscopy and/or hysterosalpingography","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1224","name":"Wheelchair spec size w/ leg","description":"Wheelchair with detachable arms, elevating legrests","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6120","name":"Elbow mold doub splt soc ste","description":"Below elbow, molded double wall split socket, step-up hinges, half cuff","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":854.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"27598","name":"Amputate lower leg at knee","description":"Disarticulation at knee","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":867.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"95012","name":"Nitric oxide exp gas deter","description":"Nitric oxide expired gas determination","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3672","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50684","name":"Injection for ureter x-ray","description":"Injection procedure for ureterography or ureteropyelography through ureterostomy or indwelling ureteral catheter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2220","name":"Dorsi & plantar flex ass/res","description":"Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":728.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0666","name":"Pneumatic appliance half leg","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, half leg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2234.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"20838","name":"Replantation foot complete","description":"Replantation, foot, complete amputation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1221","name":"Wheelchair spec size w foot","description":"Wheelchair with fixed arm, footrests","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":357.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0982","name":"Back upholstery, replacement","description":"Wheelchair accessory, back upholstery, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0489","name":"Pwr pck base combo vad, rep","description":"Power pack base for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7916.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2108","name":"Spherocylinder 4.25d/2.12-4d","description":"Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0984","name":"Add pwr tiller","description":"Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82947","name":"Assay glucose blood quant","description":"Glucose; quantitative, blood (except reagent strip)","date_of_service":"2026-05-10","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":"64620","name":"Injection treatment of nerve","description":"Destruction by neurolytic agent, intercostal nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4557","name":"Lead wires, pair","description":"Lead wires, (e.g., apnea monitor), per pair","date_of_service":"2026-05-10","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":"G0417","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":200.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"L3968","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93233","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"92550","name":"Tympanometry & reflex thresh","description":"Tympanometry and reflex threshold measurements","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A5093","name":"Ostomy accessory convex inse","description":"Ostomy accessory; convex insert","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75831","name":"Vein x-ray kidney","description":"Venography, renal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":716.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":864.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75960","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":371.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0266","name":"Hosp bed total elec w/o matt","description":"Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":834.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6573","name":"Grad com garmnt toe cap cust","description":"Gradient compression garment, toe caps, custom, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":176.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2036","name":"Kafo plas doub free knee mol","description":"Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1226.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0130","name":"Walker rigid adjust/fixed ht","description":"Walker, rigid (pickup), adjustable or fixed height","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77431","name":"Radiation therapy management","description":"Radiation therapy management with complete course of therapy consisting of 1 or 2 fractions only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1342.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2303.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6454","name":"Self-adher band w>=3in <5in/yd","description":"Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94725","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L0624","name":"Sio panel custom","description":"Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"61609","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76856","name":"Us exam pelvic complete","description":"Ultrasound, pelvic (nonobstetric), real time with image documentation; complete","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2820","name":"Soft interface below knee se","description":"Addition to lower extremity orthosis, soft interface for molded plastic, below knee section","date_of_service":"2026-05-10","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":"A6444","name":"Conform band n/s w>=5in/yd","description":"Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"70450","name":"Ct head/brain w/o dye","description":"Computed tomography, head or brain; without contrast material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0636","name":"Pt support & positioning sys","description":"Multipositional patient support system, with integrated lift, patient accessible controls","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33976","name":"Implant ventricular device","description":"Insertion of ventricular assist device; extracorporeal, biventricular","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1501.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84577","name":"Assay of feces/urobilinogen","description":"Urobilinogen, feces, quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0858","name":"Pwc gp3 hd sing pow opt s/b","description":"Power wheelchair, group 3 heavy duty, single power option, sling/solid seat/back, patient weight 301 to 450 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3415.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2186","name":"Adj motion knee jnt lerman t","description":"Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"86641","name":"Cryptococcus antibody","description":"Antibody; cryptococcus","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":527.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"62141","name":"Crnop skull defect>5 cm diam","description":"Cranioplasty for skull defect; larger than 5 cm diameter","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82154","name":"Androstanediol glucuronide","description":"Androstanediol glucuronide","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0700","name":"Ctlso a-p-l control molded","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type)","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":327.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5321","name":"Ak open end sach","description":"Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee","date_of_service":"2026-05-10","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":"72285","name":"Discography cerv/thor spine","description":"Discography, cervical or thoracic, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5595","name":"Hip disartic sach thermopls","description":"Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4392","name":"Replace afo soft interface","description":"Replacement, soft interface material, static afo","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"51772","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"11771","name":"Exc pilonidal cyst xtnsv","description":"Excision of pilonidal cyst or sinus; extensive","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":438.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":806.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-10","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":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2374.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2330","name":"Head control proximity switc","description":"Power wheelchair accessory, head control interface, proximity switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1278.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93875","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0194","name":"Air fluidized bed","description":"Air fluidized bed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"63280","name":"Bx/exc idrl spine lesn crvl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, cervical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2393.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28530","name":"Treat sesamoid bone fracture","description":"Closed treatment of sesamoid fracture","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33722","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"L3440","name":"Heel leather reinforced","description":"Heel, counter, leather reinforced","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4358","name":"Urinary leg or abdomen bag","description":"Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3590","name":"O shoe convert to sof counte","description":"Orthopedic shoe addition, convert firm shoe counter to soft counter","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"01852","name":"Anes px vn f/arm phlbrrhaphy","description":"Anesthesia for procedures on veins of forearm, wrist, and hand; phleborrhaphy","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1821.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00632","name":"Anes px lumbar sympathectomy","description":"Anesthesia for procedures in lumbar region; lumbar sympathectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"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":"2026-05-10","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":"31294","name":"Nsl/sins ndsc surg on dcmprn","description":"Nasal/sinus endoscopy, surgical, with optic nerve decompression","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1484.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J2503","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1054.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91320","name":"Sarscv2 vac 30mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 30 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","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":115.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01360","name":"Anes open px lower 1/3 femur","description":"Anesthesia for all open procedures on lower one-third of femur","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51990","name":"Laparo urethral suspension","description":"Laparoscopy, surgical; urethral suspension for stress incontinence","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15040","name":"Harvest cultured skin graft","description":"Harvest of skin for tissue cultured skin autograft, 100 sq cm or less","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":150.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0355","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21116","name":"Injection jaw joint x-ray","description":"Injection procedure for temporomandibular joint arthrography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27236","name":"Treat thigh fracture","description":"Open treatment of femoral fracture, proximal end, neck, internal fixation or prosthetic replacement","date_of_service":"2026-05-10","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":"L4631","name":"Afo, walk boot type, cus fab","description":"Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated","date_of_service":"2026-05-10","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":"L5639","name":"Below knee wood socket","description":"Addition to lower extremity, below knee, wood socket","date_of_service":"2026-05-10","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":"L5858","name":"Stance phase only","description":"Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0950","name":"Tray","description":"Wheelchair accessory, tray, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"15840","name":"Nerve palsy fascial graft","description":"Graft for facial nerve paralysis; free fascia graft (including obtaining fascia)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1100.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4383","name":"Urinary rubber pouch w/o fp","description":"Ostomy pouch, urinary, for use on faceplate, rubber, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8670","name":"Vascular graft, synthetic","description":"Vascular graft material, synthetic, implant","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1027.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"V2503","name":"Cntct lens pmma color vision","description":"Contact lens, pmma, color vision deficiency, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":648.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"63710","name":"Graft repair of spine defect","description":"Dural graft, spinal","date_of_service":"2026-05-10","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":"91055","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65850","name":"Trabeculotomy ab externo","description":"Trabeculotomy ab externo","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":506.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2207","name":"Lens sphcy bifocal 4.25-7d/.","description":"Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","date_of_service":"2026-05-10","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":"L5535","name":"Prep bk ptb open end socket","description":"Preparatory, below knee ptb type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"11970","name":"Rplcmt tiss xpndr perm implt","description":"Replacement of tissue expander with permanent implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":392.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0198","name":"Water pressure pad for mattr","description":"Water pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3285","name":"Treprostinil injection","description":"Injection, treprostinil, 1 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29845","name":"Wrist arthroscopy/surgery","description":"Arthroscopy, wrist, surgical; synovectomy, complete","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":679.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01958","name":"Anes xtrnl cephalic version","description":"Anesthesia for external cephalic version procedure","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00872","name":"Anes lithotrp esw water bath","description":"Anesthesia for lithotripsy, extracorporeal shock wave; with water bath","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"A4630","name":"Repl bat t.e.n.s. own by pt","description":"Replacement batteries, medically necessary, transcutaneous electrical stimulator, owned by patient","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4024","name":"Cast sup sht arm splnt ped f","description":"Cast supplies, short arm splint, pediatric (0-10 years), fiberglass","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50605","name":"Insert ureteral support","description":"Ureterotomy for insertion of indwelling stent, all types","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":852.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1520.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":75.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64413","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27552","name":"Treat knee dislocation","description":"Closed treatment of knee dislocation; requiring anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":529.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0111","name":"Wet mounts/ w preparations","description":"Wet mounts, including preparations of vaginal, cervical or skin specimens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":733.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"01670","name":"Anes all px vn shoulder&ax","description":"Anesthesia for all procedures on veins of shoulder and axilla","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":512.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0970","name":"Tlso corset front","description":"Tlso, corset front","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1025.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6905","name":"Hand restoration multiple fi","description":"Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2629","name":"Friction dampening arm supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"31297","name":"Nsl/sins ndsc surg sphn sins","description":"Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); sphenoid sinus ostium","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57400","name":"Dilation of vagina","description":"Dilation of vagina under anesthesia (other than local)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"93651","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88104","name":"Cytopath fl nongyn smears","description":"Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears with interpretation","date_of_service":"2026-05-10","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":"43886","name":"Gstr rstcv px opn revj port","description":"Gastric restrictive procedure, open; revision of subcutaneous port component only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21742","name":"Repair stern/nuss w/o scope","description":"Reconstructive repair of pectus excavatum or carinatum; minimally invasive approach (nuss procedure), without thoracoscopy","date_of_service":"2026-05-10","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":"76776","name":"Us exam k transpl w/doppler","description":"Ultrasound, transplanted kidney, real time and duplex doppler with image documentation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"41112","name":"Excision of tongue lesion","description":"Excision of lesion of tongue with closure; anterior two-thirds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8513","name":"Trach pros cleaning device","description":"Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"11100","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74018","name":"Radex abdomen 1 view","description":"Radiologic examination, abdomen; 1 view","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1033","name":"Wheelchair hardware headrest","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware for headrest, cushioned, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":898.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86790","name":"Virus antibody nos","description":"Antibody; virus, not elsewhere specified","date_of_service":"2026-05-10","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":"35450","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"75978","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":843.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87281","name":"Pneumocystis carinii ag if","description":"Infectious agent antigen detection by immunofluorescent technique; pneumocystis carinii","date_of_service":"2026-05-10","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":"A7032","name":"Replacement nasal cushion","description":"Cushion for use on nasal mask interface, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0389","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28515","name":"Treatment of toe fracture","description":"Closed treatment of fracture, phalanx or phalanges, other than great toe; with manipulation, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"20974","name":"Estim aid bone healg n-invas","description":"Electrical stimulation to aid bone healing; noninvasive (nonoperative)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A6252","name":"Absorpt drg >16 <=48 w/o bdr","description":"Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"67420","name":"Explore/treat eye socket","description":"Orbitotomy with bone flap or window, lateral approach (eg, kroenlein); with removal of lesion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32960","name":"Therapeutic pneumothorax","description":"Pneumothorax, therapeutic, intrapleural injection of air","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"94681","name":"O2 uptk co2 outp % o2 xtrc","description":"Oxygen uptake, expired gas analysis; including co2 output, percentage oxygen extracted","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5121","name":"Solid skin barrier 6x6","description":"Skin barrier; solid, 6 x 6 or equivalent, each","date_of_service":"2026-05-10","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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1216.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6965","name":"Shldr disartic myoelectronic","description":"Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"96120","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86822","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"61490","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2179.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76514","name":"Echo exam of eye thickness","description":"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86300","name":"Immunoassay tumor ca 15-3","description":"Immunoassay for tumor antigen, quantitative; ca 15-3 (27.29)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5503","name":"Diabetic shoe w/roller/rockr","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4246","name":"Betadine/phisohex solution","description":"Betadine or phisohex solution, per pint","date_of_service":"2026-05-10","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":"83090","name":"Assay of homocysteine","description":"Homocysteine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":804.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":"86768","name":"Salmonella antibody","description":"Antibody; salmonella","date_of_service":"2026-05-10","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":"72196","name":"Mri pelvis w/dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":782.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0505","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3560","name":"O shoe add horseshoe toe tap","description":"Orthopedic shoe addition, toe tap, horseshoe","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3430","name":"Sho heel count plast reinfor","description":"Heel, counter, plastic reinforced","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1997.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"01462","name":"Anes clsd px lower l/a/f","description":"Anesthesia for all closed procedures on lower leg, ankle, and foot","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"L3924","name":"Hfo without joints pre ots","description":"Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-05-10","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":"0330T","name":"Tear film img uni/bi w/i&r","description":"Tear film imaging, unilateral or bilateral, with interpretation and report","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"86003","name":"Allg spec ige crude xtrc ea","description":"Allergen specific ige; quantitative or semiquantitative, crude allergen extract, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"53040","name":"Drainage of urethra abscess","description":"Drainage of deep periurethral abscess","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":453.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"35321","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; axillary-brachial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":227.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1422.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27880","name":"Amputation of lower leg","description":"Amputation, leg, through tibia and fibula;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62115","name":"Reduction of skull defect","description":"Reduction of craniomegalic skull (eg, treated hydrocephalus); not requiring bone grafts or cranioplasty","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1796.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"27098","name":"Transfer tendon to pelvis","description":"Transfer, adductor to ischium","date_of_service":"2026-05-10","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":"E1028","name":"W/c manual swingaway","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1014.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25040","name":"Arthrt rdcrpl/midcarpl jt","description":"Arthrotomy, radiocarpal or midcarpal joint, with exploration, drainage, or removal of foreign body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"78725","name":"Kidney function study","description":"Kidney function study, non-imaging radioisotopic study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77328","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69020","name":"Drg xtrnl aud canal abscess","description":"Drainage external auditory canal, abscess","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":280.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87143","name":"Culture typing glc/hplc","description":"Culture, typing; gas liquid chromatography (glc) or high pressure liquid chromatography (hplc) method","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28175","name":"Resect phalanx of toe tumor","description":"Radical resection of tumor; phalanx of toe","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"94250","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4320","name":"Irrigation tray","description":"Irrigation tray with bulb or piston syringe, any purpose","date_of_service":"2026-05-10","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":"E2615","name":"Pos back post/lat wdth <22in","description":"Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":503.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"64412","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"60001","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":523.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"17307","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0493","name":"Emr pwr cbl combo vad, rep","description":"Emergency power supply cable for use with electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3003","name":"Foot insert silicone gel eac","description":"Foot, insert, removable, molded to patient model, silicone gel, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"92575","name":"Sensorineural acuity lvl tst","description":"Sensorineural acuity level test","date_of_service":"2026-05-10","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":"E0434","name":"Portable liquid 02","description":"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["QB","RR","QF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83570","name":"Assay of idh enzyme","description":"Isocitric dehydrogenase (idh)","date_of_service":"2026-05-10","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":"33500","name":"Repair heart vessel fistula","description":"Repair of coronary arteriovenous or arteriocardiac chamber fistula; with cardiopulmonary bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1354.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2410","name":"Lens variab asphericity sing","description":"Variable asphericity lens, single vision, full field, glass or plastic, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3330","name":"Lifts elevation metal extens","description":"Lift, elevation, metal extension (skate)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25900","name":"Amputation of forearm","description":"Amputation, forearm, through radius and ulna;","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1955.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"58280","name":"Hysterectomy/revise vagina","description":"Vaginal hysterectomy, with total or partial vaginectomy; with repair of enterocele","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1212.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1081.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"77427","name":"Radiation tx management x5","description":"Radiation treatment management, 5 treatments","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":195.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"25109","name":"Excise tendon forearm/wrist","description":"Excision of tendon, forearm and/or wrist, flexor or extensor, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1851","name":"Ko single upright prefab ots","description":"Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"47122","name":"Extensive removal of liver","description":"Hepatectomy, resection of liver; trisegmentectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32482","name":"Bilobectomy","description":"Removal of lung, other than pneumonectomy; 2 lobes (bilobectomy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1860.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27519","name":"Treat thigh fx growth plate","description":"Open treatment of distal femoral epiphyseal separation, includes internal fixation, when performed","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1108.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5694","name":"Ak pelvic control belt pad/l","description":"Addition to lower extremity, above knee, pelvic control belt, padded and lined","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0580","name":"Nebulizer for use w/ regulat","description":"Nebulizer, durable, glass or autoclavable plastic, bottle type, for use with regulator or flowmeter","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74241","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":450.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"35907","name":"Excision graft abdomen","description":"Excision of infected graft; abdomen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2364","name":"U1nonsealed leadacid battery","description":"Power wheelchair accessory, u-1 non-sealed lead acid battery, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95957","name":"Eeg digital analysis","description":"Digital analysis of electroencephalogram (eeg) (eg, for epileptic spike analysis)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72196","name":"Mri pelvis w/dye","description":"Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s)","date_of_service":"2026-05-10","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":"28435","name":"Cltx talus fracture w/mnpj","description":"Closed treatment of talus fracture; with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":351.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"93545","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":169.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":211.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33926","name":"Repr pul art unifocal w/cpb","description":"Repair of pulmonary artery arborization anomalies by unifocalization; with cardiopulmonary bypass","date_of_service":"2026-05-10","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":"87250","name":"Virus inoculate eggs/animal","description":"Virus isolation; inoculation of embryonated eggs, or small animal, includes observation and dissection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"74740","name":"X-ray female genital tract","description":"Hysterosalpingography, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0785","name":"Replacement impl pump cathet","description":"Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement","date_of_service":"2026-05-10","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":"39540","name":"Repair of diaphragm hernia","description":"Repair, diaphragmatic hernia (other than neonatal), traumatic; acute","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":951.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5968","name":"Multiaxial ankle w dorsiflex","description":"Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49060","name":"Drain open retroperi abscess","description":"Drainage of retroperitoneal abscess, open","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L7362","name":"Battery chrgr six volt otto","description":"Battery charger, six volt, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3974","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84377","name":"Sugars multiple qual","description":"Sugars (mono-, di-, and oligosaccharides); multiple qualitative, each specimen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"76831","name":"Echo exam uterus","description":"Saline infusion sonohysterography (sis), including color flow doppler, when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82955","name":"Assay of g6pd enzyme","description":"Glucose-6-phosphate dehydrogenase (g6pd); quantitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6241","name":"Hydrocolloid drg filler dry","description":"Hydrocolloid dressing, wound filler, dry form, sterile, per gram","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3909","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":784.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":441.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0670","name":"Seg pneum int legs/trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, 2 full legs and trunk","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"82042","name":"Other source albumin quan ea","description":"Albumin; other source, quantitative, each specimen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5652","name":"Suction susp ak/knee disart","description":"Addition to lower extremity, suction suspension, above knee or knee disarticulation socket","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50130","name":"Pyelotomy w/removal calculus","description":"Pyelotomy; with removal of calculus (pyelolithotomy, pelviolithotomy, including coagulum pyelolithotomy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":835.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5670","name":"Bk molded supracondylar susp","description":"Addition to lower extremity, below knee, molded supracondylar suspension (pts or similar)","date_of_service":"2026-05-10","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":"L2112","name":"Afo tibial fracture soft","description":"Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"A4619","name":"Face tent","description":"Face tent","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26476","name":"Tendon lengthening","description":"Lengthening of tendon, extensor, hand or finger, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":784.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"77083","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":630.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1981.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1233","name":"Rig ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, rigid, adjustable, without seating system","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0840","name":"Pwc gp2 xhd sing pow opt s/b","description":"Power wheelchair, group 2 extra heavy duty, single power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":655.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8015","name":"Ext breastprosthesis garment","description":"External breast prosthesis garment, with mastectomy form, post mastectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1008.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27884","name":"Amputation follow-up surgery","description":"Amputation, leg, through tibia and fibula; secondary closure or scar revision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86723","name":"Listeria monocytogenes","description":"Antibody; listeria monocytogenes","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93990","name":"Doppler flow testing","description":"Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":421.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"1159F","name":"Med list docd in rcrd","description":"Medication list documented in medical record (coa)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":336.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49081","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"71035","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"49020","name":"Drainage abdom abscess open","description":"Drainage of peritoneal abscess or localized peritonitis, exclusive of appendiceal abscess, open","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1590.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2313","name":"Lens sphc trifo 7.25-12/4.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":364.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74160","name":"Ct abdomen w/contrast","description":"Computed tomography, abdomen; with contrast material(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":427.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":"24566","name":"Prq skel fix epcndylr hum fx","description":"Percutaneous skeletal fixation of humeral epicondylar fracture, medial or lateral, with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":604.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70300","name":"X-ray exam of teeth","description":"Radiologic examination, teeth; single view","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"82951","name":"Glucose tolerance test (gtt)","description":"Glucose; tolerance test (gtt), 3 specimens (includes glucose)","date_of_service":"2026-05-10","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":"44150","name":"Removal of colon","description":"Colectomy, total, abdominal, without proctectomy; with ileostomy or ileoproctostomy","date_of_service":"2026-05-10","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":"0074A","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0480","name":"Percussor elect/pneum home m","description":"Percussor, electric or pneumatic, home model","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93770","name":"Determination venous press","description":"Determination of venous pressure","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":931.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"92583","name":"Select picture audiometry","description":"Select picture audiometry","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":685.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4434","name":"Ost pch urine w lock flng/ft","description":"Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"86148","name":"Anti-phospholipid antibody","description":"Anti-phosphatidylserine (phospholipid) antibody","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0492","name":"Tlso 3 piece rigid shell","description":"Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in th","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82543","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"57280","name":"Suspension of vagina","description":"Colpopexy, abdominal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0019","name":"Arm pad repl, each","description":"Arm pad, replacement only, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49400","name":"Air injection into abdomen","description":"Injection of air or contrast into peritoneal cavity (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":604.76,"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":"00124","name":"Anes px ear otoscopy","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; otoscopy","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4332","name":"Lube sterile packet","description":"Lubricant, individual sterile packet, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":364.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4038","name":"Cast sup shrt leg fiberglass","description":"Cast supplies, short leg cast, adult (11 years +), fiberglass","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31700","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0656","name":"Segmental pneumatic trunk","description":"Segmental pneumatic appliance for use with pneumatic compressor, trunk","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"61334","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1359.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6237","name":"Hydrocolld drg <=16 in w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4424","name":"Ost pch drain w bar & filter","description":"Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"41874","name":"Alveoloplasty each quadrant","description":"Alveoloplasty, each quadrant (specify)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":275.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2417.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72090","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"84075","name":"Assay alkaline phosphatase","description":"Phosphatase, alkaline;","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4357","name":"Bedside drainage bag","description":"Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each","date_of_service":"2026-05-10","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":"L3410","name":"Shoe metatarsal bar between","description":"Metatarsal bar wedge, between sole","date_of_service":"2026-05-10","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":"L3470","name":"Shoe heel thomas extend to b","description":"Heel, thomas extended to ball","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78103","name":"Bone marrow imaging mult","description":"Bone marrow imaging; multiple areas","date_of_service":"2026-05-10","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":"87276","name":"Influenza a ag if","description":"Infectious agent antigen detection by immunofluorescent technique; influenza a virus","date_of_service":"2026-05-10","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":"L4060","name":"Replace high roll cuff","description":"Replace high roll cuff","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":220.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71015","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86644","name":"Cmv antibody","description":"Antibody; cytomegalovirus (cmv)","date_of_service":"2026-05-10","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":"L0636","name":"Lso sagittal rigid panel cus","description":"Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressu","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"82690","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78190","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":321.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51703","name":"Insert bladder cath complex","description":"Insertion of temporary indwelling bladder catheter; complicated (eg, altered anatomy, fractured catheter/balloon)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00880","name":"Anes maj lwr abd vessel nos","description":"Anesthesia for procedures on major lower abdominal vessels; not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.16,"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":"A6591","name":"Urinary cath suc pump","description":"External urinary catheter; non-disposable, for use with suction pump, per month","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37761","name":"Ligate leg veins open","description":"Ligation of perforator vein(s), subfascial, open, including ultrasound guidance, when performed, 1 leg","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88263","name":"Chromosome analysis 45","description":"Chromosome analysis; count 45 cells for mosaicism, 2 karyotypes, with banding","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"78018","name":"Thyroid met imaging body","description":"Thyroid carcinoma metastases imaging; whole body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35472","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67917","name":"Repair eyelid defect","description":"Repair of ectropion; extensive (eg, tarsal strip operations)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"77011","name":"Ct scan for localization","description":"Computed tomography guidance for stereotactic localization","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93980","name":"Penile vascular study","description":"Duplex scan of arterial inflow and venous outflow of penile vessels; complete study","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1110","name":"Ring flange plas/leather mol","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75959","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66983","name":"Cataract surg w/iol 1 stage","description":"Intracapsular cataract extraction with insertion of intraocular lens prosthesis (1 stage procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":668.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","date_of_service":"2026-05-10","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":"00770","name":"Anes px maj abd blood vessel","description":"Anesthesia for all procedures on major abdominal blood vessels","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":"L5722","name":"Knee-shin pneum swg frct exo","description":"Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80152","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3740","name":"Cuffs adj lock w/ active con","description":"Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"86645","name":"Cmv antibody igm","description":"Antibody; cytomegalovirus (cmv), igm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"27137","name":"Revise hip joint replacement","description":"Revision of total hip arthroplasty; acetabular component only, with or without autograft or allograft","date_of_service":"2026-05-10","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":"28062","name":"Removal of foot fascia","description":"Fasciectomy, plantar fascia; radical (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43195","name":"Esophagoscopy rigid balloon","description":"Esophagoscopy, rigid, transoral; with balloon dilation (less than 30 mm diameter)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69140","name":"Remove ear canal lesion(s)","description":"Excision exostosis(es), external auditory canal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1002.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"32606","name":"Thoracoscopy w/bx med space","description":"Thoracoscopy, diagnostic (separate procedure); mediastinal space, with biopsy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":577.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4318","name":"Fem urinary cup w/wo attch","description":"Female external urinary collection cup, with or without ring attachment, per day","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":183.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"65426","name":"Removal of eye lesion","description":"Excision or transposition of pterygium; with graft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":464.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"73030","name":"X-ray exam of shoulder","description":"Radiologic examination, shoulder; complete, minimum of 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0735","name":"Non-invasive vagus nerv stim","description":"Non-invasive vagus nerve stimulator","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":902.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"66940","name":"Extraction of lens","description":"Removal of lens material; extracapsular (other than 66840, 66850, 66852)","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"85280","name":"Clot factor xii hageman","description":"Clotting; factor xii (hageman)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0851","name":"Pwc gp 3 hd cap chair","description":"Power wheelchair, group 3 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93501","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1072.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0439","name":"Stationary liquid 02","description":"Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0243","name":"Toilet rail","description":"Toilet rail, each","date_of_service":"2026-05-10","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":"47510","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"95010","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"77073","name":"Bone length studies","description":"Bone length studies (orthoroentgenogram, scanogram)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"47715","name":"Excision of bile duct cyst","description":"Excision of choledochal cyst","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1323.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78811","name":"Pet image ltd area","description":"Positron emission tomography (pet) imaging; limited area (eg, chest, head/neck)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01961","name":"Anes cesarean delivery only","description":"Anesthesia for cesarean delivery only","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":809.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7009","name":"Nebulizer reservoir bottle","description":"Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88106","name":"Cytopath fl nongyn filter","description":"Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple filter method with interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6567","name":"G com garment neck/head cust","description":"Gradient compression garment, neck/head, custom, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1822","name":"Adjust ankle extension dev","description":"Dynamic adjustable ankle extension only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":"G6023","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"27479","name":"Surgery to stop leg growth","description":"Arrest, epiphyseal, any method (eg, epiphysiodesis); combined distal femur, proximal tibia and fibula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78191","name":"Platelet survival study","description":"Platelet survival study","date_of_service":"2026-05-10","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":"40812","name":"Excise/repair mouth lesion","description":"Excision of lesion of mucosa and submucosa, vestibule of mouth; with simple repair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":226.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E1800","name":"Adjust elbow ext & flex dev","description":"Dynamic adjustable elbow extension and flexion device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"29040","name":"Appl bdy cst sho to hip head","description":"Application of body cast, shoulder to hips; including head, minerva type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":144.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52612","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":537.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":718.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27648","name":"Injection for ankle x-ray","description":"Injection procedure for ankle arthrography","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"V2020","name":"Vision svcs frames purchases","description":"Frames, purchases","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1093.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0942","name":"Cervical head harness/halter","description":"Cervical head harness/halter","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-10","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":"77413","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"37140","name":"Revision of circulation","description":"Venous anastomosis, open; portocaval","date_of_service":"2026-05-10","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":"20612","name":"Aspirate/inj ganglion cyst","description":"Aspiration and/or injection of ganglion cyst(s) any location","date_of_service":"2026-05-10","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":"37565","name":"Ligation int jugular vein","description":"Ligation, internal jugular vein","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":795.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":534.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33504","name":"Coronary artery graft","description":"Repair of anomalous coronary artery from pulmonary artery origin; by graft, with cardiopulmonary bypass","date_of_service":"2026-05-10","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":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-10","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":"L8470","name":"Pros sock single ply bk","description":"Prosthetic sock, single ply, fitting, below knee, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1545.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":501.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3982","name":"Upper ext fx orthosis rad/ul","description":"Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":610.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93527","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0984","name":"Protect body sock ea pre ots","description":"Protective body sock, prefabricated, off-the-shelf, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1624.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1461.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4349","name":"Disposable male external cat","description":"Male external catheter, with or without adhesive, disposable, each","date_of_service":"2026-05-10","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":"K0002","name":"Stnd hemi (low seat) whlchr","description":"Standard hemi (low seat) wheelchair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"50010","name":"Renal exploration","description":"Renal exploration, not necessitating other specific procedures","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43198","name":"Esophagosc flex trnsn biopsy","description":"Esophagoscopy, flexible, transnasal; with biopsy, single or multiple","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2850","name":"Femoral lgth sock fx or equa","description":"Addition to lower extremity orthosis, femoral length sock, fracture or equal, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4427","name":"Ost pch drain/barr lk flng/f","description":"Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"25920","name":"Amputate hand at wrist","description":"Disarticulation through wrist;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42835","name":"Removal of adenoids","description":"Adenoidectomy, secondary; younger than age 12","date_of_service":"2026-05-10","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":"23520","name":"Cltx strnclav dislc w/o mnpj","description":"Closed treatment of sternoclavicular dislocation; without manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2221","name":"Solid caster tire repl, each","description":"Manual wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"30906","name":"Repeat control of nosebleed","description":"Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, any method; subsequent","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82370","name":"X-ray assay calculus","description":"Calculus; x-ray diffraction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0631","name":"Lso sag r an/pos pnl pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous a","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"31360","name":"Removal of larynx","description":"Laryngectomy; total, without radical neck dissection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1581.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":574.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":"92533","name":"Caloric vestibular test","description":"Caloric vestibular test, each irrigation (binaural, bithermal stimulation constitutes 4 tests)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"C1300","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":63.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-10","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":"E2632","name":"Offset/lat rocker arm w/ela","description":"Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01744","name":"Anes opn/arthrs elbw rpr hum","description":"Anesthesia for open or surgical arthroscopic procedures of the elbow; repair of nonunion or malunion of humerus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"92971","name":"Cardioassist external","description":"Cardioassist-method of circulatory assist; external","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-10","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":"77762","name":"Apply intrcav radiat interm","description":"Intracavitary radiation source application; intermediate","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":230.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5312","name":"Knee disart, sach ft, endo","description":"Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3720","name":"Forearm/arm cuffs free motio","description":"Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73070","name":"X-ray exam of elbow","description":"Radiologic examination, elbow; 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"58292","name":"Vag hyst t/o & repair compl","description":"Vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s), with repair of enterocele","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":845.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"G6002","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27675","name":"Repair lower leg tendons","description":"Repair, dislocating peroneal tendons; without fibular osteotomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74410","name":"Urography nfs drip&/bolus","description":"Urography, infusion, drip technique and/or bolus technique;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"58353","name":"Endometr ablate thermal","description":"Endometrial ablation, thermal, without hysteroscopic guidance","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"28193","name":"Removal of foot foreign body","description":"Removal of foreign body, foot; complicated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"33967","name":"Insert i-aort percut device","description":"Insertion of intra-aortic balloon assist device, percutaneous","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"U0001","name":"2019-ncov diagnostic p","description":"Cdc 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6646","name":"Multipo locking shoulder jnt","description":"Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1536.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27725","name":"Repair of lower leg","description":"Repair of nonunion or malunion, tibia; by synostosis, with fibula, any method","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1028.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0114","name":"Crutch underarm pair no wood","description":"Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0629","name":"Seat lift mech, non-electric","description":"Seat lift mechanism, non-electric, any type","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93741","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"65430","name":"Corneal smear","description":"Scraping of cornea, diagnostic, for smear and/or culture","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6578","name":"Gradient comp sleeve","description":"Gradient  compression arm sleeve, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6588","name":"Shdr fair lead cable molded","description":"Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"97545","name":"Work hardening","description":"Work hardening/conditioning; initial 2 hours","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59150","name":"Treat ectopic pregnancy","description":"Laparoscopic treatment of ectopic pregnancy; without salpingectomy and/or oophorectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2301","name":"Lens sphere trifocal 4.12-7.","description":"Sphere, trifocal, plus or minus 4.12 to plus or minus 7.00d, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L7364","name":"Twelve volt battery utah/equ","description":"Twelve volt battery, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6232","name":"Hydrogel dsg>16<=48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size greater than 16 sq. in., but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64868","name":"Fusion of facial/other nerve","description":"Anastomosis; facial-hypoglossal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":814.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8691","name":"Aoi snd proc repl excl actua","description":"Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1007","name":"Pwr seat combo w/shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29805","name":"Sho arthrs dx +- synovial bx","description":"Arthroscopy, shoulder, diagnostic, with or without synovial biopsy (separate procedure)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3975","name":"Sewhfo cap design w/o jnt cf","description":"Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":526.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1353","name":"Oxygen supplies regulator","description":"Regulator","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"34802","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":518.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43327","name":"Esoph fundoplasty lap","description":"Esophagogastric fundoplasty partial or complete; laparotomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86727","name":"Lymph choriomeningitis ab","description":"Antibody; lymphocytic choriomeningitis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-05-10","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":"78272","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"49656","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"28150","name":"Removal of toe","description":"Phalangectomy, toe, each toe","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78185","name":"Spleen imaging","description":"Spleen imaging only, with or without vascular flow","date_of_service":"2026-05-10","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":"E2000","name":"Gastric suction pump hme mdl","description":"Gastric suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"25690","name":"Cltx lunate dislc w/mnpj","description":"Closed treatment of lunate dislocation, with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":542.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"62100","name":"Repair brain fluid leakage","description":"Craniotomy for repair of dural/cerebrospinal fluid leak, including surgery for rhinorrhea/otorrhea","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3763","name":"Ewho rigid w/o jnts cf","description":"Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1135.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0488","name":"Tlso rigid lined pre one pie","description":"Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts g","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["KM"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1825.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"59821","name":"Treatment of miscarriage","description":"Treatment of missed abortion, completed surgically; second trimester","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":413.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":289.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":356.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33975","name":"Implant ventricular device","description":"Insertion of ventricular assist device; extracorporeal, single ventricle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1345.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"57300","name":"Repair rectum-vagina fistula","description":"Closure of rectovaginal fistula; vaginal or transanal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":568.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L2622","name":"Hip joint adjustable flexion","description":"Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"L5673","name":"Socket insert w lock mech","description":"Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00908","name":"Anes perineal prostatectomy","description":"Anesthesia for; perineal prostatectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"33720","name":"Repair of heart defect","description":"Repair sinus of valsalva aneurysm, with cardiopulmonary bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1342.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86674","name":"Giardia lamblia antibody","description":"Antibody; giardia lamblia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44137","name":"Remove intestinal allograft","description":"Removal of transplanted intestinal allograft, complete","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86304","name":"Immunoassay tumor ca 125","description":"Immunoassay for tumor antigen, quantitative; ca 125","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01829","name":"Anes dx arthroscopic px wrst","description":"Anesthesia for diagnostic arthroscopic procedures on the wrist","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32810","name":"Close chest after drainage","description":"Closure of chest wall following open flap drainage for empyema (clagett type procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0854","name":"Pwc gp 3 xhd seat/back","description":"Power wheelchair, group 3 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"S3819","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47125","name":"Partial removal of liver","description":"Hepatectomy, resection of liver; total left lobectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3326.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3786.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4234","name":"J-cell batt for glucose mon","description":"Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KL","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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1948.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93925","name":"Lower extremity study","description":"Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":684.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"28405","name":"Cltx calcaneal fx w/mnpj","description":"Closed treatment of calcaneal fracture; with manipulation","date_of_service":"2026-05-10","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":"49215","name":"Excise sacral spine tumor","description":"Excision of presacral or sacrococcygeal tumor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2304.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"46762","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"74440","name":"X-ray male genital tract","description":"Vasography, vesiculography, or epididymography, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6055","name":"Wrst mold sock w/exp interfa","description":"Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2125.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6550","name":"Neg pres wound ther drsg set","description":"Wound care set, for negative pressure wound therapy electrical pump, includes all supplies and accessories","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0853","name":"Pwc gp 3 vhd cap chair","description":"Power wheelchair, group 3 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":"25118","name":"Excise wrist tendon sheath","description":"Synovectomy, extensor tendon sheath, wrist, single compartment;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"81422","name":"Fetal chrmoml microdeltj","description":"Fetal chromosomal microdeletion(s) genomic sequence analysis (eg, digeorge syndrome, cri-du-chat syndrome), circulating cell-free fetal dna in maternal blood","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"58340","name":"Catheter for hysterography","description":"Catheterization and introduction of saline or contrast material for saline infusion sonohysterography (sis) or hysterosalpingography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":72.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"65175","name":"Removal of ocular implant","description":"Removal of ocular implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8002","name":"Brst prsth bra & bilat form","description":"Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1791.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":112.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":"76070","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":166.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49323","name":"Laparo drain lymphocele","description":"Laparoscopy, surgical; with drainage of lymphocele to peritoneal cavity","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1020","name":"Kyphosis pad","description":"Addition to ctlso or scoliosis orthosis, kyphosis pad","date_of_service":"2026-05-10","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":"97003","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42205","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate, with closure of alveolar ridge; soft tissue only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1121.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"29876","name":"Arthrs knee surg synvct maj","description":"Arthroscopy, knee, surgical; synovectomy, major, 2 or more compartments (eg, medial or lateral)","date_of_service":"2026-05-10","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":"82387","name":"Assay of cathepsin-d","description":"Cathepsin-d","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68330","name":"Revise eyelid lining","description":"Repair of symblepharon; conjunctivoplasty, without graft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":436.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11950","name":"Subq njx filling matrl 1cc/<","description":"Subcutaneous injection of filling material (eg, collagen); 1 cc or less","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2402","name":"Neg press wound therapy pump","description":"Negative pressure wound therapy electrical pump, stationary or portable","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63662","name":"Remove spine eltrd plate","description":"Removal of spinal neurostimulator electrode plate/paddle(s) placed via laminotomy or laminectomy, including fluoroscopy, when performed","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0855","name":"Cervical traction equipment","description":"Cervical traction equipment not requiring additional stand or frame","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1563","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2106","name":"Spherocylinder 4.00d/>6.00d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":253.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4657","name":"Syringe w/wo needle","description":"Syringe, with or without needle, each","date_of_service":"2026-05-10","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":"L1720","name":"Legg perthes orthosis trilat","description":"Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated","date_of_service":"2026-05-10","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":"01130","name":"Anes body cast appl/revj","description":"Anesthesia for body cast application or revision","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86317","name":"Immunoassay infectious agent","description":"Immunoassay for infectious agent antibody, quantitative, not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0163","name":"Commode chair with fixed arm","description":"Commode chair, mobile or stationary, with fixed arms","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"L3763","name":"Ewho rigid w/o jnts cf","description":"Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":341.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0860","name":"Pwc gp3 vhd sing pow opt s/b","description":"Power wheelchair, group 3 very heavy duty, single power option, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00534","name":"Anes insertion/rplcmt cvdfb","description":"Anesthesia for transvenous insertion or replacement of pacing cardioverter-defibrillator","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["TC"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9370","name":"Vincristine sulfate 1 mg inj","description":"Vincristine sulfate, 1 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0188","name":"Synthetic sheepskin pad","description":"Synthetic sheepskin pad","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"88381","name":"Microdissection manual","description":"Microdissection (ie, sample preparation of microscopically identified target); manual","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75650","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"28485","name":"Optx metatarsal fx each","description":"Open treatment of metatarsal fracture, includes internal fixation, when performed, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74018","name":"Radex abdomen 1 view","description":"Radiologic examination, abdomen; 1 view","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33542","name":"Removal of heart lesion","description":"Myocardial resection (eg, ventricular aneurysmectomy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"G0392","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"S8990","name":"Pt or manip for maint","description":"Physical or manipulative therapy performed for maintenance rather than restoration","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"47716","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1177.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70260","name":"X-ray exam of skull","description":"Radiologic examination, skull; complete, minimum of 4 views","date_of_service":"2026-05-10","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":"43261","name":"Endo cholangiopancreatograph","description":"Endoscopic retrograde cholangiopancreatography (ercp); with biopsy, single or multiple","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"00770","name":"Anes px maj abd blood vessel","description":"Anesthesia for all procedures on major abdominal blood vessels","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86146","name":"Beta-2 glycoprotein antibody","description":"Beta 2 glycoprotein i antibody, each","date_of_service":"2026-05-10","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":"E0155","name":"Walker wheel attachment,pair","description":"Wheel attachment, rigid pick-up walker, per pair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88275","name":"Cytogenetics 100-300","description":"Molecular cytogenetics; interphase in situ hybridization, analyze 100-300 cells","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-10","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":"33285","name":"Insj subq car rhythm mntr","description":"Insertion, subcutaneous cardiac rhythm monitor, including programming","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":626.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0220","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L6880","name":"Elec hand ind art digits","description":"Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25000","name":"Incision of tendon sheath","description":"Incision, extensor tendon sheath, wrist (eg, de quervains disease)","date_of_service":"2026-05-10","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":"29450","name":"Application clubfoot cast","description":"Application of clubfoot cast with molding or manipulation, long or short leg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0348","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"G6002","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"75980","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"75553","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"80190","name":"Assay of procainamide","description":"Procainamide;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":569.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7501","name":"Tracheostoma valve w diaphra","description":"Tracheostoma valve, including diaphragm, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E0628","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37160","name":"Revision of circulation","description":"Venous anastomosis, open; caval-mesenteric","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1947.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4770","name":"Blood collection tube/vacuum","description":"Blood collection tube, vacuum, for dialysis, per 50","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A7004","name":"Disposable nebulizer sml vol","description":"Small volume nonfiltered pneumatic nebulizer, disposable","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"94400","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"24150","name":"Rad rescj tum dstl/shft hum","description":"Radical resection of tumor, shaft or distal humerus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1163.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6882","name":"Microprocessor control uplmb","description":"Microprocessor control feature, addition to upper limb prosthetic terminal device","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"64716","name":"Revision of cranial nerve","description":"Neuroplasty and/or transposition; cranial nerve (specify)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":583.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"43620","name":"Removal of stomach","description":"Gastrectomy, total; with esophagoenterostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2034.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":683.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25491","name":"Prophylactic tx ulna","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; ulna","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1200.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1200","name":"Diphenhydramine hcl injectio","description":"Injection, diphenhydramine hcl, up to 50 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52000","name":"Cystourethroscopy","description":"Cystourethroscopy (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":126.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"36593","name":"Declot vascular device","description":"Declotting by thrombolytic agent of implanted vascular access device or catheter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"S8185","name":"Flutter device","description":"Flutter device","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26478","name":"Lengthening of hand tendon","description":"Lengthening of tendon, flexor, hand or finger, each tendon","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1114.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":586.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82482","name":"Assay rbc cholinesterase","description":"Cholinesterase; rbc","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L1110","name":"Ring flange plas/leather mol","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7522","name":"Trach/laryn tube stainless","description":"Tracheostomy/laryngectomy tube, stainless steel or equal (sterilizable and reusable), each","date_of_service":"2026-05-10","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":"K0039","name":"Leg strap h style each","description":"Leg strap, h style, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","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":"E0850","name":"Traction stand free standing","description":"Traction stand, free standing, cervical traction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33367","name":"Replace aortic valve w/byp","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; cardiopulmonary bypass support with percutaneous peripheral arterial and venous cannulation (eg, femoral vessels) (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6232","name":"Hydrogel dsg>16<=48 sq in","description":"Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size greater than 16 sq. in., but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"00750","name":"Anes hrna rpr upr abd nos","description":"Anesthesia for hernia repairs in upper abdomen; not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"33211","name":"Insert card electrodes dual","description":"Insertion or replacement of temporary transvenous dual chamber pacing electrodes (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78606","name":"Brain image w/flow 4 + views","description":"Brain imaging, minimum 4 static views; with vascular flow","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91318","name":"Sarscov2 vac 3mcg trs-suc im","description":"Severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) vaccine, mrna-lnp, spike protein, 3 mcg/0.3 ml dosage, tris-sucrose formulation, for intramuscular use","date_of_service":"2026-05-10","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":172.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"24655","name":"Cltx rdl head/nck fx w/mnpj","description":"Closed treatment of radial head or neck fracture; with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":452.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1614.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-10","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":"49010","name":"Exploration behind abdomen","description":"Exploration, retroperitoneal area with or without biopsy(s) (separate procedure)","date_of_service":"2026-05-10","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":"E0606","name":"Drainage board postural","description":"Postural drainage board","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":"84060","name":"Assay acid phosphatase","description":"Phosphatase, acid; total","date_of_service":"2026-05-10","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":"V2115","name":"Lens lenticular bifocal","description":"Lenticular, (myodisc), per lens, single vision","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6605","name":"G com bandage padded foam","description":"Gradient compression bandaging supply, padded foam, per linear yard, any width, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"L3762","name":"Eo rigid w/o joints pre ots","description":"Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"82438","name":"Assay other fluid chlorides","description":"Chloride; other source","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L6037","name":"Postop dsg cast chg handfing","description":"Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"88319","name":"Enzyme histochemistry","description":"Special stain including interpretation and report; group iii, for enzyme constituents","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2296.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7037","name":"Pos airway pressure tubing","description":"Tubing used with positive airway pressure device","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"A4611","name":"Heavy duty battery","description":"Battery, heavy duty; replacement for patient owned ventilator","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27146","name":"Incision of hip bone","description":"Osteotomy, iliac, acetabular or innominate bone;","date_of_service":"2026-05-10","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":"73120","name":"X-ray exam of hand","description":"Radiologic examination, hand; 2 views","date_of_service":"2026-05-10","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":"85384","name":"Fibrinogen activity","description":"Fibrinogen; activity","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2000","name":"Gastric suction pump hme mdl","description":"Gastric suction pump, home model, portable or stationary, electric","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"67909","name":"Revise eyelid defect","description":"Reduction of overcorrection of ptosis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":265.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88400","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"83700","name":"Lipopro bld electrophoretic","description":"Lipoprotein, blood; electrophoretic separation and quantitation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KF"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":952.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2625","name":"Adj skin pro/pos wc cus>=22","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4379","name":"Urinary plastic pouch w fcpl","description":"Ostomy pouch, urinary, with faceplate attached, plastic, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"74350","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q0171","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6676","name":"Harness figure of 8 dual con","description":"Upper extremity addition, harness, (e.g., figure of eight type), dual cable design","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2363","name":"Gr24 sealed leadacid battery","description":"Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"42235","name":"Repair palate","description":"Repair of anterior palate, including vomer flap","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":561.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20922","name":"Removal of fascia for graft","description":"Fascia lata graft; by incision and area exposure, complex or sheet","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":546.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6700","name":"Ue add ext power myoel","description":"Upper extremity addition, external powered feature, myoelectronic control module, additional emg inputs, pattern-recognition decoding intent movement","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"G0347","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5990","name":"User adjustable heel height","description":"Addition to lower extremity prosthesis, user adjustable heel height","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0801","name":"Pov group 1 hd 301-450 lbs","description":"Power operated vehicle, group 1 heavy duty, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"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":"2026-05-10","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":"L1920","name":"Afo sing upright w/ adjust s","description":"Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64859","name":"Nerve surgery","description":"Suture of each additional major peripheral nerve (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1346.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8430","name":"Prosthetic sock multi ply ak","description":"Prosthetic sock, multiple ply, above knee, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0116","name":"Crutch underarm each no wood","description":"Crutch, underarm, other than wood, adjustable or fixed, with pad, tip, handgrip, with or without shock absorber, each","date_of_service":"2026-05-10","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":"85032","name":"Manual cell count each","description":"Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77785","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87497","name":"Cytomeg dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); cytomegalovirus, quantification","date_of_service":"2026-05-10","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":"31080","name":"Removal of frontal sinus","description":"Sinusotomy frontal; obliterative without osteoplastic flap, brow incision (includes ablation)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"86308","name":"Heterophile antibody screen","description":"Heterophile antibodies; screening","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1369.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2628","name":"Fabrication & fitting","description":"Fabrication and fitting of ocular conformer","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1801.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0465","name":"Home vent invasive interface","description":"Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube)","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"70240","name":"X-ray exam pituitary saddle","description":"Radiologic examination, sella turcica","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85730","name":"Thromboplastin time partial","description":"Thromboplastin time, partial (ptt); plasma or whole blood","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"A6202","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76645","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"93701","name":"Bioimpedance cv analysis","description":"Bioimpedance-derived physiologic cardiovascular analysis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2398","name":"Wc dynamic pos back hardware","description":"Wheelchair accessory, dynamic positioning hardware for back","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"G0204","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78456","name":"Acute venous thrombus image","description":"Acute venous thrombosis imaging, peptide","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":269.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2184","name":"Limited motion knee joint","description":"Addition to lower extremity fracture orthosis, limited motion knee joint","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":455.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"70310","name":"X-ray exam of teeth","description":"Radiologic examination, teeth; partial examination, less than full mouth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3675","name":"So vest canvas/web pre ots","description":"Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":683.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2298","name":"Pwr seat elev sys for crt","description":"Complex rehabilitative power wheelchair accessory, power seat elevation system, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"57170","name":"Fitting of diaphragm/cap","description":"Diaphragm or cervical cap fitting with instructions","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-10","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":"15833","name":"Exc excessive skin leg","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); leg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67015","name":"Release of eye fluid","description":"Aspiration or release of vitreous, subretinal or choroidal fluid, pars plana approach (posterior sclerotomy)","date_of_service":"2026-05-10","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":"E1172","name":"Wheelchair amputee detach ar","description":"Amputee wheelchair, detachable arms (desk or full length) without footrests or legrest","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21750","name":"Repair of sternum separation","description":"Closure of median sternotomy separation with or without debridement (separate procedure)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64611","name":"Chemodenerv saliv glands","description":"Chemodenervation of parotid and submandibular salivary glands, bilateral","date_of_service":"2026-05-10","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":"A4215","name":"Sterile needle","description":"Needle, sterile, any size, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31578","name":"Largsc w/removal lesion","description":"Laryngoscopy, flexible; with removal of lesion(s), non-laser","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49560","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":812.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":688.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0630","name":"Lso r post pnl sj-t9 pre cst","description":"Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdom","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2091.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"00162","name":"Anes px nose&sinus rad surg","description":"Anesthesia for procedures on nose and accessory sinuses; radical surgery","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1882.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"52355","name":"Cystouretero w/excise tumor","description":"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with resection of ureteral or renal pelvic tumor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":547.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"62355","name":"Remove spinal canal catheter","description":"Removal of previously implanted intrathecal or epidural catheter","date_of_service":"2026-05-10","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":"76098","name":"X-ray exam surgical specimen","description":"Radiological examination, surgical specimen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68540","name":"Remove tear gland lesion","description":"Excision of lacrimal gland tumor; frontal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":916.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1342.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0974","name":"W/ch access anti-rollback","description":"Manual wheelchair accessory, anti-rollback device, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G0438","name":"Ppps, initial visit","description":"Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"85260","name":"Clot factor x stuart-power","description":"Clotting; factor x (stuart-prower)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0015","name":"Detach non-adj ht armrst rep","description":"Detachable, non-adjustable height armrest, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"J9170","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":297.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0191","name":"Protector heel or elbow","description":"Heel or elbow protector, each","date_of_service":"2026-05-10","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":"00530","name":"Anes perm transvns pm insj","description":"Anesthesia for permanent transvenous pacemaker insertion","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"27040","name":"Biopsy of soft tissues","description":"Biopsy, soft tissue of pelvis and hip area; superficial","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1768.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":156.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72192","name":"Ct pelvis w/o dye","description":"Computed tomography, pelvis; without contrast material","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":898.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6638","name":"Elec lock on manual pw elbow","description":"Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59100","name":"Remove uterus lesion","description":"Hysterotomy, abdominal (eg, for hydatidiform mole, abortion)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":754.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":306.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1412.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":969.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":631.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2323","name":"Special joystick handle","description":"Power wheelchair accessory, specialty joystick handle for hand control interface, prefabricated","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"A5105","name":"Urinary suspensory","description":"Urinary suspensory with leg bag, with or without tube, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":433.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5960","name":"Endo hip ultra-light materia","description":"Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E0642","name":"Dynamic standing frame","description":"Standing frame/table system, mobile (dynamic stander), any size including pediatric","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21070","name":"Remove coronoid process","description":"Coronoidectomy (separate procedure)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2218","name":"Foam propulsion tire each","description":"Manual wheelchair accessory, foam propulsion tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L6020","name":"Part hand no fingers","description":"Partial hand, no finger remaining","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"43605","name":"Biopsy of stomach","description":"Biopsy of stomach, by laparotomy","date_of_service":"2026-05-10","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":"E1812","name":"Knee ext/flex w act res ctrl","description":"Dynamic knee, extension/flexion device with active resistance control","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"75676","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29700","name":"Rmvl/bivlv gauntlet boot/cst","description":"Removal or bivalving; gauntlet, boot or body cast","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86747","name":"Parvovirus antibody","description":"Antibody; parvovirus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1814.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"E2397","name":"Pwc acc, lith-based battery","description":"Power wheelchair accessory, lithium-based battery, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1409.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87480","name":"Candida dna dir probe","description":"Infectious agent detection by nucleic acid (dna or rna); candida species, direct probe technique","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"A4221","name":"Supp non-insulin inf cath/wk","description":"Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs  separately)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E1310","name":"Whirlpool non-portable","description":"Whirlpool, non-portable (built-in type)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"50290","name":"Excision perinephric cyst","description":"Excision of perinephric cyst","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":994.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43300","name":"Repair of esophagus","description":"Esophagoplasty (plastic repair or reconstruction), cervical approach; without repair of tracheoesophageal fistula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":744.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"00210","name":"Anes intracranial px nos","description":"Anesthesia for intracranial procedures; not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5698","name":"Ak/knee disartic silesian ba","description":"Addition to lower extremity, above knee or knee disarticulation, silesian bandage","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"Q9952","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92563","name":"Tone decay hearing test","description":"Tone decay test","date_of_service":"2026-05-10","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":"G0297","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0765","name":"Nerve stimulator for tx n&v","description":"Fda approved nerve stimulator, for treatment of nausea and vomiting","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"E1083","name":"Hemi-wheelchair fixed arms","description":"Hemi-wheelchair, fixed full length arms, swing away detachable elevating leg rest","date_of_service":"2026-05-10","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":"K0077","name":"Fr cstr asmb sol tire rep ea","description":"Front caster assembly, complete, with solid tire, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":562.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8042","name":"Orbital prosthesis","description":"Orbital prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KM"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"87075","name":"Cultr bacteria except blood","description":"Culture, bacterial; any source, except blood, anaerobic with isolation and presumptive identification of isolates","date_of_service":"2026-05-10","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":"E2510","name":"Sgd w multi methods msg/accs","description":"Speech generating device, synthesized speech, permitting multiple methods of message formulation and multiple methods of device access","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78315","name":"Bone imaging 3 phase","description":"Bone and/or joint imaging; 3 phase study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":38.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"35481","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":517.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82163","name":"Assay of angiotensin ii","description":"Angiotensin ii","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29580","name":"Strapping unna boot","description":"Strapping; unna boot","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"39541","name":"Repair of diaphragm hernia","description":"Repair, diaphragmatic hernia (other than neonatal), traumatic; chronic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8010","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":76.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65093","name":"Revise eye with implant","description":"Evisceration of ocular contents; with implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":717.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5676","name":"Bk knee joints single axis p","description":"Additions to lower extremity, below knee, knee joints, single axis, pair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"57300","name":"Repair rectum-vagina fistula","description":"Closure of rectovaginal fistula; vaginal or transanal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70150","name":"X-ray exam of facial bones","description":"Radiologic examination, facial bones; complete, minimum of 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A4463","name":"Surgical dress holder reuse","description":"Surgical dressing holder, reusable, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46604","name":"Anoscopy and dilation","description":"Anoscopy; with dilation (eg, balloon, guide wire, bougie)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74420","name":"Urography rtrgr +-kub","description":"Urography, retrograde, with or without kub","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1298.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":532.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67028","name":"Injection eye drug","description":"Intravitreal injection of a pharmacologic agent (separate procedure)","date_of_service":"2026-05-10","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":"66185","name":"Revise aqueous shunt eye","description":"Revision of aqueous shunt to extraocular equatorial plate reservoir; with graft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33236","name":"Remove electrode/thoracotomy","description":"Removal of permanent epicardial pacemaker and electrodes by thoracotomy; single lead system, atrial or ventricular","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"81020","name":"Urinalysis glass test","description":"Urinalysis; 2 or 3 glass test","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0836","name":"Pwc gp2 std sing pow opt cap","description":"Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":497.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"83805","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":644.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83902","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"74291","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"26433","name":"Repair finger tendon","description":"Repair of extensor tendon, distal insertion, primary or secondary; without graft (eg, mallet finger)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0822","name":"Pwc gp 2 std seat/back","description":"Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"E1905","name":"Vr cbt therapy","description":"Virtual reality cognitive behavioral therapy device (cbt), including pre-programmed therapy software","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24605","name":"Tx clsd elbow dislc req anes","description":"Treatment of closed elbow dislocation; requiring anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":533.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2607","name":"Skin pro/pos wc cus wd <22in","description":"Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"A9538","name":"Tc99m pyrophosphate","description":"Technetium tc-99m pyrophosphate, diagnostic, per study dose, up to 25 millicuries","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"76092","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":104.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5610","name":"Above knee hydracadence","description":"Addition to lower extremity, endoskeletal system, above knee, hydracadence system","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2660","name":"Thoracic control thoracic ba","description":"Addition to lower extremity, thoracic control, thoracic band","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"77327","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"29345","name":"Application of long leg cast","description":"Application of long leg cast (thigh to toes);","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":83.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-05-10","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":"00550","name":"Anes for sternal debridement","description":"Anesthesia for sternal debridement","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":249.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"90813","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0657","name":"Segmental pneumatic chest","description":"Segmental pneumatic appliance for use with pneumatic compressor, chest","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"0540T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"95908","name":"Nrv cndj tst 3-4 studies","description":"Nerve conduction studies; 3-4 studies","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"77057","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82963","name":"Assay of glucosidase","description":"Glucosidase, beta","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"26742","name":"Treat finger fracture each","description":"Closed treatment of articular fracture, involving metacarpophalangeal or interphalangeal joint; with manipulation, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":378.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":711.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"29705","name":"Rmvl/bivlv full arm/leg cast","description":"Removal or bivalving; full arm or full leg cast","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"88182","name":"Cell marker study","description":"Flow cytometry, cell cycle or dna analysis","date_of_service":"2026-05-10","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":"A4620","name":"Variable concentration mask","description":"Variable concentration mask","date_of_service":"2026-05-10","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":"86590","name":"Streptokinase antibody","description":"Streptokinase, antibody","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":800.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3761","name":"Eo, adj lock joint prefab ot","description":"Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2319","name":"Lens trifocal seg width > 28","description":"Trifocal seg width over 28 mm","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2328","name":"Head/extremity control inter","description":"Power wheelchair accessory, head control or extremity control interface, electronic, proportional, including all related electronics and fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2467.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E0238","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2203","name":"Frame depth less than 22 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"E1003","name":"Pwr seat recline","description":"Wheelchair accessory, power seating system, recline only, without shear reduction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"77293","name":"Respirator motion mgmt simul","description":"Respiratory motion management simulation (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"30220","name":"Insert nasal septal button","description":"Insertion, nasal septal prosthesis (button)","date_of_service":"2026-05-10","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":"97542","name":"Wheelchair mngment training","description":"Wheelchair management (eg, assessment, fitting, training), each 15 minutes","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7039","name":"Filter, non disposable w pap","description":"Filter, non disposable, used with positive airway pressure device","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"91011","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"90644","name":"Hib-mency vacc 6wk-18m0 im","description":"Meningococcal conjugate vaccine, serogroups c & y and haemophilus influenzae type b vaccine (hib-mency), 4 dose schedule, when administered to children 6 weeks-18 months of age, for intramuscular use","date_of_service":"2026-05-10","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":"percentage","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L5701","name":"Replace socket above knee","description":"Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"86171","name":"Complement fixation each","description":"Complement fixation tests, each antigen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1033.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"77013","name":"Ct guide for tissue ablation","description":"Computed tomography guidance for, and monitoring of, parenchymal tissue ablation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"32854","name":"Lung transplant with bypass","description":"Lung transplant, double (bilateral sequential or en bloc); with cardiopulmonary bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4195.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":44.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2216","name":"Foam filled propulsion tire","description":"Manual wheelchair accessory, foam filled propulsion tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2321","name":"Lenticular lens, trifocal","description":"Lenticular lens, per lens, trifocal","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"53621","name":"Dilate urethra stricture","description":"Dilation of urethral stricture by passage of filiform and follower, male; subsequent","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":84.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7186","name":"Electron elbow child switch","description":"Electronic elbow, child, variety village or equal, switch controlled","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82977","name":"Assay of ggt","description":"Glutamyltransferase, gamma (ggt)","date_of_service":"2026-05-10","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":"55812","name":"Extensive prostate surgery","description":"Prostatectomy, perineal radical; with lymph node biopsy(s) (limited pelvic lymphadenectomy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1301.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":197.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"70250","name":"X-ray exam of skull","description":"Radiologic examination, skull; less than 4 views","date_of_service":"2026-05-10","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":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45307","name":"Proctosigmoidoscopy fb","description":"Proctosigmoidoscopy, rigid; with removal of foreign body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77328","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1298","name":"Wheelchair spec seat depth/w","description":"Special wheelchair seat depth and/or width, by construction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33363","name":"Replace aortic valve open","description":"Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; open axillary artery approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1848.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":558.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95933","name":"Blink reflex test","description":"Orbicularis oculi (blink) reflex, by electrodiagnostic testing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6550","name":"Shldr disar prosth tiss shap","description":"Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0995","name":"Wc calf rest, pad replacemnt","description":"Wheelchair accessory, calf rest/pad, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"25248","name":"Remove forearm foreign body","description":"Exploration with removal of deep foreign body, forearm or wrist","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":349.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0479","name":"Power module combo vad, rep","description":"Power module for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2219","name":"Lens bifocal seg width over","description":"Bifocal seg width over 28 mm","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5631","name":"Ak/knee disartic acrylic soc","description":"Addition to lower extremity, above knee or knee disarticulation, acrylic socket","date_of_service":"2026-05-10","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":"84085","name":"Assay of rbc pg6d enzyme","description":"Phosphogluconate, 6-, dehydrogenase, rbc","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"21310","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"60254","name":"Extensive thyroid surgery","description":"Thyroidectomy, total or subtotal for malignancy; with radical neck dissection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1938.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83540","name":"Assay of iron","description":"Iron","date_of_service":"2026-05-10","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":"44660","name":"Repair bowel-bladder fistula","description":"Closure of enterovesical fistula; without intestinal or bladder resection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1072.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84550","name":"Assay of blood/uric acid","description":"Uric acid; blood","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72120","name":"X-ray bend only l-s spine","description":"Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":179.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68115","name":"Exc les conjunctiva >1 cm","description":"Excision of lesion, conjunctiva; over 1 cm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"58900","name":"Biopsy of ovary(s)","description":"Biopsy of ovary, unilateral or bilateral (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93524","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1951","name":"Afo spiral prefab custom","description":"Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"47120","name":"Partial removal of liver","description":"Hepatectomy, resection of liver; partial lobectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1947.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25295","name":"Release wrist/forearm tendon","description":"Tenolysis, flexor or extensor tendon, forearm and/or wrist, single, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77055","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":138.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0461","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A5113","name":"Latex leg strap","description":"Leg strap; latex, replacement only, per set","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6645","name":"Shoulder flexion-abduction j","description":"Upper extremity addition, shoulder flexion-abduction joint, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"64413","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L3974","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"76511","name":"Oph us dx quan a-scan only","description":"Ophthalmic ultrasound, diagnostic; quantitative a-scan only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59425","name":"Antepartum care only","description":"Antepartum care only; 4-6 visits","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3919","name":"Ho w/o joints cf","description":"Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4562","name":"Pessary reusable nonrubber","description":"Pessary, reusable, non rubber, any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"57305","name":"Repair rectum-vagina fistula","description":"Closure of rectovaginal fistula; abdominal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":967.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":321.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1020","name":"Residual limb support system","description":"Residual limb support system for wheelchair, any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80174","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27265","name":"Treat hip dislocation","description":"Closed treatment of post hip arthroplasty dislocation; without anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":473.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25210","name":"Removal of wrist bone","description":"Carpectomy; 1 bone","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"43460","name":"Pressure treatment esophagus","description":"Esophagogastric tamponade, with balloon (sengstaken type)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":163.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1930","name":"Afo plastic","description":"Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":"43328","name":"Esoph fundoplasty thor","description":"Esophagogastric fundoplasty partial or complete; thoracotomy","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"20910","name":"Remove cartilage for graft","description":"Cartilage graft; costochondral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":393.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00172","name":"Anes ntroral px rpr clft pal","description":"Anesthesia for intraoral procedures, including biopsy; repair of cleft palate","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":245.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26185","name":"Remove finger bone","description":"Sesamoidectomy, thumb or finger (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":462.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6579","name":"Custom grad com glove med","description":"Gradient compression glove, custom, medium weight, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"42804","name":"Biopsy of upper nose/throat","description":"Biopsy; nasopharynx, visible lesion, simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2204","name":"Frame depth 22 to 25 in","description":"Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":185.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63190","name":"Incise spine nrv >2 segmnts","description":"Laminectomy with rhizotomy; more than 2 segments","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1057.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":456.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4438","name":"Adhesive clip ext ens contr","description":"Adhesive clip applied to the skin to secure external electrical nerve stimulator controller, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"00162","name":"Anes px nose&sinus rad surg","description":"Anesthesia for procedures on nose and accessory sinuses; radical surgery","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77328","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-05-10","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":"63250","name":"Revise spinal cord vsls crvl","description":"Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; cervical","date_of_service":"2026-05-10","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":"61708","name":"Revise circulation to head","description":"Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intracranial electrothrombosis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2341.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31380","name":"Partial removal of larynx","description":"Partial laryngectomy (hemilaryngectomy); anterovertical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1913.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1193.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1030","name":"W/c vent tray gimbaled","description":"Wheelchair accessory, ventilator tray, gimbaled","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00922","name":"Anes px male gent sem ves","description":"Anesthesia for procedures on male genitalia (including open urethral procedures); seminal vesicles","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"L4010","name":"Replace trilateral socket br","description":"Replace trilateral socket brim","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["95","CR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"40702","name":"Repair cleft lip/nasal","description":"Plastic repair of cleft lip/nasal deformity; primary bilateral, 1 of 2 stages","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":803.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4458","name":"Reusable enema bag","description":"Enema bag with tubing, reusable","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"V2718","name":"Fresnell prism press-on lens","description":"Press-on lens, fresnell prism, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":863.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76642","name":"Ultrasound breast limited","description":"Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0802","name":"Pov group 1 vhd 451-600 lbs","description":"Power operated vehicle, group 1 very heavy duty, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"55120","name":"Removal of scrotum lesion","description":"Removal of foreign body in scrotum","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":468.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42950","name":"Reconstruction of throat","description":"Pharyngoplasty (plastic or reconstructive operation on pharynx)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6197","name":"Alginate drsg >16 <=48 sq in","description":"Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"54800","name":"Biopsy of epididymis","description":"Biopsy of epididymis, needle","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0585","name":"Nebulizer w/ compressor & he","description":"Nebulizer, with compressor and heater","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":629.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"L3702","name":"Eo w/o joints cf","description":"Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":"36640","name":"Insertion catheter artery","description":"Arterial catheterization for prolonged infusion therapy (chemotherapy), cutdown","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"47480","name":"Incision of gallbladder","description":"Cholecystotomy or cholecystostomy, open, with exploration, drainage, or removal of calculus (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":810.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2387","name":"Foam filled caster tire","description":"Power wheelchair accessory, foam filled caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0042","name":"Standard size ftplate rep ea","description":"Standard size footplate, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","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":"52402","name":"Cysto trurl rescj ejacul dux","description":"Cystourethroscopy with transurethral resection or incision of ejaculatory ducts","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8682","name":"Implt neurostim radiofq rec","description":"Implantable neurostimulator radiofrequency receiver","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74260","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88321","name":"Consltj&reprt sld prep elswr","description":"Consultation and report on referred slides prepared elsewhere","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"65772","name":"Correction of astigmatism","description":"Corneal relaxing incision for correction of surgically induced astigmatism","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"86638","name":"Q fever antibody","description":"Antibody; coxiella burnetii (q fever)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1312.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95920","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0864","name":"Pwc gp3 xhd mult pow opt s/b","description":"Power wheelchair, group 3 extra heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":256.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25927","name":"Amputation of hand","description":"Transmetacarpal amputation;","date_of_service":"2026-05-10","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":"78070","name":"Parathyroid planar imaging","description":"Parathyroid planar imaging (including subtraction, when performed);","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82696","name":"Assay of etiocholanolone","description":"Etiocholanolone","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93315","name":"Echo transesophageal","description":"Transesophageal echocardiography for congenital cardiac anomalies; including probe placement, image acquisition, interpretation and report","date_of_service":"2026-05-10","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":"L3630","name":"Trans shoe solid stirrup new","description":"Transfer of an orthosis from one shoe to another, solid stirrup, new","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00842","name":"Anes iper px amniocentesis","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; amniocentesis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J1670","name":"Tetanus immune globulin inj","description":"Injection, tetanus immune globulin, human, up to 250 units","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":970.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":714.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84480","name":"Assay triiodothyronine (t3)","description":"Triiodothyronine t3; total (tt-3)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1300","name":"Body jacket mold to patient","description":"Other scoliosis procedure, body jacket molded to patient model","date_of_service":"2026-05-10","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":"E1832","name":"Sps finger device","description":"Static progressive stretch finger device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27395","name":"Lengthening of thigh tendons","description":"Lengthening of hamstring tendon; multiple tendons, bilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1054.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1030.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2371","name":"Gr27 sealed leadacid battery","description":"Power wheelchair accessory, group 27 sealed lead acid battery, (e.g., gel cell, absorbed glassmat), each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93233","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"95044","name":"Patch/application tests","description":"Patch or application test(s) (specify number of tests)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"E2329","name":"Head control nonproportional","description":"Power wheelchair accessory, head control interface, contact switch mechanism, nonproportional, including all related electronics, mechanical stop switch, mechanical direction change switch, head array, and fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01960","name":"Anes vaginal delivery only","description":"Anesthesia for vaginal delivery only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"ATP10","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"21150","name":"Rcnstj mdfc lefrtii ant ntru","description":"Reconstruction midface, lefort ii; anterior intrusion (eg, treacher-collins syndrome)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1344.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0910","name":"Trapeze bar attached to bed","description":"Trapeze bars, a/k/a patient helper, attached to bed, with grab bar","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":279.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1676.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"90620","name":"Menb-4c vaccine im","description":"Meningococcal recombinant protein and outer membrane vesicle vaccine, serogroup b (menb-4c), for intramuscular use","date_of_service":"2026-05-10","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":286.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-10","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":"L4205","name":"Ortho dvc repair per 15 min","description":"Repair of orthotic device, labor component, per 15 minutes","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":597.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":693.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5628","name":"Test socket hemipelvectomy","description":"Addition to lower extremity, test socket, hemipelvectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"00902","name":"Anes anorectal px","description":"Anesthesia for; anorectal procedure","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42806","name":"Biopsy of upper nose/throat","description":"Biopsy; nasopharynx, survey for unknown primary lesion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":103.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27607","name":"Treat lower leg bone lesion","description":"Incision (eg, osteomyelitis or bone abscess), leg or ankle","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2324","name":"Chin cup interface","description":"Power wheelchair accessory, chin cup for chin control interface","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0572","name":"Aerosol compressor adjust pr","description":"Aerosol compressor, adjustable pressure, light duty for intermittent use","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69501","name":"Mastoidectomy","description":"Transmastoid antrotomy (simple mastoidectomy)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75880","name":"Vein x-ray eye socket","description":"Venography, orbital, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3900","name":"Hinge extension/flex wrist/f","description":"Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1174.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0826","name":"Pwc gp 2 vhd seat/back","description":"Power wheelchair, group 2 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"51700","name":"Irrigation of bladder","description":"Bladder irrigation, simple, lavage and/or instillation","date_of_service":"2026-05-10","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":"87487","name":"Chlmyd pneum dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia pneumoniae, quantification","date_of_service":"2026-05-10","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":"93530","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"A6010","name":"Collagen based wound filler","description":"Collagen based wound filler, dry form, sterile, per gram of collagen","date_of_service":"2026-05-10","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":"15570","name":"Skin pedicle flap trunk","description":"Formation of direct or tubed pedicle, with or without transfer; trunk","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":779.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L0700","name":"Ctlso a-p-l control molded","description":"Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type)","date_of_service":"2026-05-10","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":"L3931","name":"Whfo nontorsion joint prefab","description":"Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":45.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72126","name":"Ct neck spine w/dye","description":"Computed tomography, cervical spine; with contrast material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":299.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":869.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1213.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5122","name":"Solid skin barrier 8x8","description":"Skin barrier; solid, 8 x 8 or equivalent, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","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":"78461","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75956","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77321","name":"Special teletx port plan","description":"Special teletherapy port plan, particles, hemibody, total body","date_of_service":"2026-05-10","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":"28675","name":"Repair of toe dislocation","description":"Open treatment of interphalangeal joint dislocation, includes internal fixation, when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":463.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26130","name":"Remove wrist joint lining","description":"Synovectomy, carpometacarpal joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":537.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":818.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2307","name":"Lens sphcy trifocal 4.25-7/.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"L5651","name":"Ak flex inner socket ext fra","description":"Addition to lower extremity, above knee, flexible inner socket, external frame","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":596.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1653","name":"Ho abduction static ots","description":"Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50800","name":"Implant ureter in bowel","description":"Ureteroenterostomy, direct anastomosis of ureter to intestine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":753.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"E2366","name":"Battery charger, single mode","description":"Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A6258","name":"Transparent film >16<=48 in","description":"Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing","date_of_service":"2026-05-10","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":"28250","name":"Revision of foot fascia","description":"Division of plantar fascia and muscle (eg, steindler stripping) (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":491.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0492","name":"Emr pwr cbl elec vad, rep","description":"Emergency power supply cable for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":761.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5071","name":"Urinary pouch w/barrier","description":"Ostomy pouch, urinary; with barrier attached (1 piece), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"51550","name":"Partial removal of bladder","description":"Cystectomy, partial; simple","date_of_service":"2026-05-10","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":"82340","name":"Assay of calcium in urine","description":"Calcium; urine quantitative, timed specimen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"84133","name":"Assay of urine potassium","description":"Potassium; urine","date_of_service":"2026-05-10","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":"E0199","name":"Dry pressure pad for mattres","description":"Dry pressure pad for mattress, standard mattress length and width","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"25455","name":"Epiphysl arrst dstl rds&ulna","description":"Epiphyseal arrest by epiphysiodesis or stapling; distal radius and ulna","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":966.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44202","name":"Lap enterectomy","description":"Laparoscopy, surgical; enterectomy, resection of small intestine, single resection and anastomosis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1502.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2204.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43135","name":"Removal of esophagus pouch","description":"Diverticulectomy of hypopharynx or esophagus, with or without myotomy; thoracic approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1187.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":794.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67906","name":"Repair eyelid defect","description":"Repair of blepharoptosis; superior rectus technique with fascial sling (includes obtaining fascia)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":544.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2383","name":"Insert, pneum wheel drive","description":"Power wheelchair accessory, insert for pneumatic drive wheel tire (removable), any type, any size, replacement only, each","date_of_service":"2026-05-10","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":"01112","name":"Anes bone marrow aspir&/bx","description":"Anesthesia for bone marrow aspiration and/or biopsy, anterior or posterior iliac crest","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"20500","name":"Njx sinus tract therapeutic","description":"Injection of sinus tract; therapeutic (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0739","name":"Repair/svc dme non-oxygen eq","description":"Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25420","name":"Repair/graft radius & ulna","description":"Repair of nonunion or malunion, radius and ulna; with autograft (includes obtaining graft)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1706.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0781","name":"External ambulatory infus pu","description":"Ambulatory infusion pump, single or multiple channels, electric or battery operated, with administrative equipment, worn by patient","date_of_service":"2026-05-10","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":"G0122","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J1070","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"E0957","name":"W/c medial thigh support","description":"Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7013","name":"Disposable compressor filter","description":"Filter, disposable, used with aerosol compressor or ultrasonic generator","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2571.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2227","name":"Gear reduction drive wheel","description":"Manual wheelchair accessory, gear reduction drive wheel, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1275.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0112","name":"Crutch underarm pair wood","description":"Crutches underarm, wood, adjustable or fixed, pair, with pads, tips and handgrips","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["QB","RR","QF"]}],"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":"2026-05-10","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":"A7001","name":"Nondisposable pump canister","description":"Canister, non-disposable, used with suction pump, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25085","name":"Incision of wrist capsule","description":"Capsulotomy, wrist (eg, contracture)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":374.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"92522","name":"Evaluate speech production","description":"Evaluation of speech sound production (eg, articulation, phonological process, apraxia, dysarthria);","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":308.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"26580","name":"Repair cleft hand","description":"Repair cleft hand","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93303","name":"Echo transthoracic","description":"Transthoracic echocardiography for congenital cardiac anomalies; complete","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41140","name":"Removal of tongue","description":"Glossectomy; complete or total, with or without tracheostomy, without radical neck dissection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2453.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5712","name":"Knee-shin exo frict swg & st","description":"Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"84060","name":"Assay acid phosphatase","description":"Phosphatase, acid; total","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"84392","name":"Assay of urine sulfate","description":"Sulfate, urine","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0196","name":"Gel pressure mattress","description":"Gel pressure mattress","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"25805","name":"Arthrd wrist w/sliding graft","description":"Arthrodesis, wrist; with sliding graft","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82953","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"26560","name":"Repair of web finger","description":"Repair of syndactyly (web finger) each web space; with skin flaps","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":236.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1455.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0561","name":"Humidifier nonheated w pap","description":"Humidifier, non-heated, used with positive airway pressure device","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":372.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00176","name":"Anes intraoral px rad surg","description":"Anesthesia for intraoral procedures, including biopsy; radical surgery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"90806","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86615","name":"Bordetella antibody","description":"Antibody; bordetella","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6629","name":"Lamination collar w/ couplin","description":"Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":39.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01420","name":"Anes cst appl rmv/rpr kne jt","description":"Anesthesia for all cast applications, removal, or repair involving knee joint","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82634","name":"Deoxycortisol","description":"Deoxycortisol, 11-","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35671","name":"Bpg pop-tibl/-prnl artery","description":"Bypass graft, with other than vein; popliteal-tibial or -peroneal artery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1408.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"E2213","name":"Pneumatic prop tire insert","description":"Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73115","name":"Contrast x-ray of wrist","description":"Radiologic examination, wrist, arthrography, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5688","name":"Bk waist belt webbing","description":"Addition to lower extremity, below knee, waist belt, webbing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"51590","name":"Remove bladder/revise tract","description":"Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including intestine anastomosis;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2071.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"69440","name":"Exploration of middle ear","description":"Middle ear exploration through postauricular or ear canal incision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":554.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95903","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":29.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":147.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":751.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":408.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93982","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"64650","name":"Chemodenerv eccrine glands","description":"Chemodenervation of eccrine glands; both axillae","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"76821","name":"Middle cerebral artery echo","description":"Doppler velocimetry, fetal; middle cerebral artery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1023.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8628","name":"Cid ext controller repl","description":"Cochlear implant, external controller component, replacement","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"29520","name":"Strapping of hip","description":"Strapping; hip","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"48153","name":"Pancreatectomy","description":"Pancreatectomy, proximal subtotal with near-total duodenectomy, choledochoenterostomy and duodenojejunostomy (pylorus-sparing, whipple-type procedure); with pancreatojejunostomy","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0861","name":"Pwc gp3 std mult pow opt s/b","description":"Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82800","name":"Blood ph","description":"Gases, blood, ph only","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"73090","name":"X-ray exam of forearm","description":"Radiologic examination; forearm, 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85014","name":"Hematocrit","description":"Blood count; hematocrit (hct)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"90465","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"Q0490","name":"Emr pwr source elec vad, rep","description":"Emergency power source for use with electric ventricular assist device, replacement only","date_of_service":"2026-05-10","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":"33915","name":"Remove lung artery emboli","description":"Pulmonary artery embolectomy; without cardiopulmonary bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1417.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":"77079","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38101","name":"Removal of spleen partial","description":"Splenectomy; partial (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":787.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88107","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3973","name":"Sewho airplane w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":877.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"88285","name":"Chromosome count additional","description":"Chromosome analysis; additional cells counted, each study","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35484","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00870","name":"Anes xtrprtl cystolithotomy","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; cystolithotomy","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82307","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92342","name":"Fit spectacles multifocal","description":"Fitting of spectacles, except for aphakia; multifocal, other than bifocal","date_of_service":"2026-05-10","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":"L5984","name":"Endoskeletal axial rotation","description":"All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1204.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"E0856","name":"Cervic collar w air bladders","description":"Cervical traction device, with inflatable air bladder(s)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92506","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":146.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":350.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8684","name":"Radiof trsmtr implt scrl neu","description":"Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"51060","name":"Removal of ureter stone","description":"Transvesical ureterolithotomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8040","name":"Nasal prosthesis","description":"Nasal prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KN"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1620.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3650","name":"So 8 abd restraint pre ots","description":"Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0239","name":"Hydrocollator unit portable","description":"Hydrocollator unit, portable","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2628","name":"Metal frame recipro hip & ca","description":"Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables","date_of_service":"2026-05-10","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":"15430","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":388.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","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":"29131","name":"Appl finger splint dynamic","description":"Application of finger splint; dynamic","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3460","name":"Shoe heel new rubber standar","description":"Heel, new rubber, standard","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3334","name":"Shoe lifts elevation heel /i","description":"Lift, elevation, heel, per inch","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L2350","name":"Prosthetic type socket molde","description":"Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for ptb afo orthoses)","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3170","name":"Foot plas heel stabi pre ots","description":"Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each","date_of_service":"2026-05-10","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":"L0625","name":"Lo flex l1-below l5 pre ots","description":"Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":404.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"86382","name":"Neutralization test viral","description":"Neutralization test, viral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20802","name":"Replantation arm complete","description":"Replantation, arm (includes surgical neck of humerus through elbow joint), complete amputation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2911.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1010.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":662.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7170","name":"Electronic elbow hosmer swit","description":"Electronic elbow, hosmer or equal, switch controlled","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":959.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"82013","name":"Acetylcholinesterase assay","description":"Acetylcholinesterase","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"35236","name":"Repair blvsl vn grf uxtr","description":"Repair blood vessel with vein graft; upper extremity","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":874.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1006","name":"Pwr seat combo w/o shear","description":"Wheelchair accessory, power seating system, combination tilt and recline, without shear reduction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":643.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20205","name":"Deep muscle biopsy","description":"Biopsy, muscle; deep","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":71.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4615","name":"Cannula nasal","description":"Cannula, nasal","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"20912","name":"Remove cartilage for graft","description":"Cartilage graft; nasal septum","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":389.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A5114","name":"Foam/fabric leg strap","description":"Leg strap; foam or fabric, replacement only, per set","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5220","name":"No knee joint with artic ali","description":"Above knee, short prosthesis, no knee joint (stubbies), with articulated ankle/foot, dynamically aligned, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4255","name":"Glucose monitor platforms","description":"Platforms for home blood glucose monitor, 50 per box","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L8330","name":"Truss add to std pad scrotal","description":"Truss, addition to standard pad, scrotal pad","date_of_service":"2026-05-10","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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69950","name":"Incise inner ear nerve","description":"Vestibular nerve section, transcranial approach","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L2350","name":"Prosthetic type socket molde","description":"Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for ptb afo orthoses)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72132","name":"Ct lumbar spine w/dye","description":"Computed tomography, lumbar spine; with contrast material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35182","name":"Rpr cgen av fistula thrx&abd","description":"Repair, congenital arteriovenous fistula; thorax and abdomen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2108.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7027","name":"Combination oral/nasal mask","description":"Combination oral/nasal mask, used with continuous positive airway pressure device, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2113","name":"Spherocylindr 7.25d/4.25-6d","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":617.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83036","name":"Hemoglobin glycosylated a1c","description":"Hemoglobin; glycosylated (a1c)","date_of_service":"2026-05-10","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":"E1237","name":"Rgd ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, rigid, adjustable, without seating system","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"G6016","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":223.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87077","name":"Culture aerobic identify","description":"Culture, bacterial; aerobic isolate, additional methods required for definitive identification, each isolate","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1599.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A8000","name":"Soft protect helmet prefab","description":"Helmet, protective, soft, prefabricated, includes all components and accessories","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":262.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01404","name":"Anes opn/arthrs disrtcj knee","description":"Anesthesia for open or surgical arthroscopic procedures on knee joint; disarticulation at knee","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"00912","name":"Anes trurl px rescj bldr tum","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of bladder tumor(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31526","name":"Dx laryngoscopy w/oper scope","description":"Laryngoscopy direct, with or without tracheoscopy; diagnostic, with operating microscope or telescope","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75820","name":"Vein x-ray arm/leg","description":"Venography, extremity, unilateral, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2208","name":"Cylinder tank carrier","description":"Wheelchair accessory, cylinder tank carrier, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"00474","name":"Anes prtl rib rescj rad px","description":"Anesthesia for partial rib resection; radical procedures (eg, pectus excavatum)","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":319.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"95975","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":111.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2225","name":"Caster wheel excludes tire","description":"Manual wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0287","name":"Amphotericin b lipid complex","description":"Injection, amphotericin b lipid complex, 10 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0667","name":"Seg pneumatic appl full leg","description":"Segmental pneumatic appliance for use with pneumatic compressor, full leg","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"G2250","name":"Remot img sub by pt, non e/m","description":"Remote assessment of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related service provided within the previous 7 days nor leading to a service or p","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51550","name":"Partial removal of bladder","description":"Cystectomy, partial; simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":786.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"53000","name":"Incision of urethra","description":"Urethrotomy or urethrostomy, external (separate procedure); pendulous urethra","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2309","name":"Lens sphc trifocal 4.25-7/4.","description":"Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-10","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":"Q4041","name":"Cast sup lng leg splnt plstr","description":"Cast supplies, long leg splint, adult (11 years +), plaster","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50600","name":"Exploration of ureter","description":"Ureterotomy with exploration or drainage (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1036.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"82985","name":"Assay of glycated protein","description":"Glycated protein","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37605","name":"Ligation int/com carotid art","description":"Ligation; internal or common carotid artery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6582","name":"Gradient comp gauntlet","description":"Gradient compression gauntlet, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"62252","name":"Csf shunt reprogram","description":"Reprogramming of programmable cerebrospinal shunt","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0960","name":"W/c shoulder harness/straps","description":"Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":919.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"63286","name":"Bx/exc idrl imed lesn thrc","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, thoracic","date_of_service":"2026-05-10","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":"E0990","name":"Wheelchair elevating leg res","description":"Wheelchair accessory, elevating leg rest, complete assembly, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"87487","name":"Chlmyd pneum dna quant","description":"Infectious agent detection by nucleic acid (dna or rna); chlamydia pneumoniae, quantification","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0966","name":"Wheelchair head rest extensi","description":"Manual wheelchair accessory, headrest extension, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2502","name":"Sgd prerec msg >8min <=20min","description":"Speech generating device, digitized speech, using pre-recorded messages, greater than 8 minutes but less than or equal to 20 minutes recording time","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"38564","name":"Removal abdomen lymph nodes","description":"Limited lymphadenectomy for staging (separate procedure); retroperitoneal (aortic and/or splenic)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":774.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6607","name":"G com bandage tub protct lyr","description":"Gradient compression bandaging supply, tubular protective absorption layer, per linear yard, any width, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":695.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["KE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"83898","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":457.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E0734","name":"Ext up limb tremor stim wris","description":"External upper limb tremor stimulator of the peripheral nerves of the wrist","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"38243","name":"Transplj hematopoietic boost","description":"Hematopoietic progenitor cell (hpc); hpc boost","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78020","name":"Thyroid met uptake","description":"Thyroid carcinoma metastases uptake (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","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":"78701","name":"Kidney imaging with flow","description":"Kidney imaging morphology; with vascular flow","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"65135","name":"Insert ocular implant","description":"Insertion of ocular implant secondary; after enucleation, muscles not attached to implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"22851","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"36200","name":"Place catheter in aorta","description":"Introduction of catheter, aorta","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"92583","name":"Select picture audiometry","description":"Select picture audiometry","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":447.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0469","name":"Tlso rig fram pelvic pre ots","description":"Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal and coronal ","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"44650","name":"Repair bowel fistula","description":"Closure of enteroenteric or enterocolic fistula","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1100","name":"Ring flange plastic/leather","description":"Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0673","name":"Pressure pneum appl half leg","description":"Segmental gradient pressure pneumatic appliance, half leg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61545","name":"Excision of brain tumor","description":"Craniotomy with elevation of bone flap; for excision of craniopharyngioma","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3589.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0941","name":"Gravity assisted traction de","description":"Gravity assisted traction device, any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2809.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8659","name":"Interphalangeal joint repl","description":"Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"01999","name":"Unlisted anes procedure","description":"Unlisted anesthesia procedure(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.26,"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":"86668","name":"Francisella tularensis","description":"Antibody; francisella tularensis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2614","name":"Position back cush wd>=22in","description":"Positioning wheelchair back cushion, posterior, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0040","name":"Adjustable angle footplate","description":"Adjustable angle footplate, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L6615","name":"Disconnect locking wrist uni","description":"Upper extremity addition, disconnect locking wrist unit","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6522","name":"G com garment arm nighttime","description":"Gradient compression garment, arm, padded, for nighttime use, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"87001","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2200","name":"Lens spher bifoc plano 4.00d","description":"Sphere, bifocal, plano to plus or minus 4.00d, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"A4313","name":"Catheter w/bag 3-way","description":"Insertion tray without drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":305.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"27727","name":"Repair of lower leg","description":"Repair of congenital pseudarthrosis, tibia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1221.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"35361","name":"Rechanneling of artery","description":"Thromboendarterectomy, including patch graft, if performed; combined aortoiliac","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97532","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"74249","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"25250","name":"Removal of wrist prosthesis","description":"Removal of wrist prosthesis; (separate procedure)","date_of_service":"2026-05-10","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":"69120","name":"Removal of external ear","description":"Excision external ear; complete amputation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":484.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"19030","name":"Njx px only mam ducto/glcto","description":"Injection procedure only for mammary ductogram or galactogram","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":235.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3213","name":"Benesch boot pair child","description":"Benesch boot, pair, child","date_of_service":"2026-05-10","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":"82239","name":"Bile acids total","description":"Bile acids; total","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2373","name":"Hand/chin ctrl spec joystick","description":"Power wheelchair accessory, hand or chin control interface, compact remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":181.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":"29870","name":"Arthrs knee dx w/wo syn bx","description":"Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"27727","name":"Repair of lower leg","description":"Repair of congenital pseudarthrosis, tibia","date_of_service":"2026-05-10","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":"35456","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":495.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":889.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6970","name":"Interscapular-thor switch ct","description":"Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1002","name":"Pwr seat tilt","description":"Wheelchair accessory, power seating system, tilt only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"15944","name":"Exc isch pr ulc skn flp clsr","description":"Excision, ischial pressure ulcer, with skin flap closure;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":982.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"40830","name":"Repair mouth laceration","description":"Closure of laceration, vestibule of mouth; 2.5 cm or less","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33918","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1918.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"24430","name":"Rpr non/mal humerus wo graft","description":"Repair of nonunion or malunion, humerus; without graft (eg, compression technique)","date_of_service":"2026-05-10","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":"47600","name":"Cholecystectomy","description":"Cholecystectomy;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":958.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":844.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2220","name":"Solid propuls tire, repl, ea","description":"Manual wheelchair accessory, solid (rubber/plastic) propulsion tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"L6680","name":"Test sock wrist disart/bel e","description":"Upper extremity addition, test socket, wrist disarticulation or below elbow","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36815","name":"Insertion of cannula","description":"Insertion of cannula for hemodialysis, other purpose (separate procedure); arteriovenous, external revision, or closure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":184.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2377","name":"Expandable controller, initl","description":"Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"A6238","name":"Hydrocolld drg >16<=48 w/bdr","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-10","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":"75831","name":"Vein x-ray kidney","description":"Venography, renal, unilateral, selective, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"33720","name":"Repair of heart defect","description":"Repair sinus of valsalva aneurysm, with cardiopulmonary bypass","date_of_service":"2026-05-10","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":"58565","name":"Hysteroscopy sterilization","description":"Hysteroscopy, surgical; with bilateral fallopian tube cannulation to induce occlusion by placement of permanent implants","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86308","name":"Heterophile antibody screen","description":"Heterophile antibodies; screening","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78306","name":"Bone imaging whole body","description":"Bone and/or joint imaging; whole body","date_of_service":"2026-05-10","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":"00450","name":"Anes px clav&scapula nos","description":"Anesthesia for procedures on clavicle and scapula; not otherwise specified","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6022","name":"Collagen drsg>16<=48 sq in","description":"Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":430.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"77777","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"97026","name":"Infrared therapy","description":"Application of a modality to 1 or more areas; infrared","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"26105","name":"Biopsy finger joint lining","description":"Arthrotomy with biopsy; metacarpophalangeal joint, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"K0050","name":"Ratchet assembly replacement","description":"Ratchet assembly, replacement only","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0006","name":"Heavy duty wheelchair","description":"Heavy duty wheelchair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0162","name":"Sitz bath chair","description":"Sitz bath chair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77066","name":"Dx mammo incl cad bi","description":"Diagnostic mammography, including computer-aided detection (cad) when performed; bilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0439","name":"Stationary liquid 02","description":"Stationary liquid oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, & tubing","date_of_service":"2026-05-10","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":"72052","name":"X-ray exam neck spine 6/>vws","description":"Radiologic examination, spine, cervical; 6 or more views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"95933","name":"Blink reflex test","description":"Orbicularis oculi (blink) reflex, by electrodiagnostic testing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"78630","name":"Cerebrospinal fluid scan","description":"Cerebrospinal fluid flow, imaging (not including introduction of material); cisternography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92563","name":"Tone decay hearing test","description":"Tone decay test","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1821","name":"Replacement interface spsd","description":"Replacement soft interface material/cuffs for bi-directional static progressive stretch device","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"82600","name":"Assay of cyanide","description":"Cyanide","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"93528","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"64476","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q0498","name":"Holster elec/combo vad, rep","description":"Holster for use with electric or electric/pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"31576","name":"Laryngoscopy with biopsy","description":"Laryngoscopy, flexible; with biopsy(ies)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76978","name":"Us trgt dyn mbubb 1st les","description":"Ultrasound, targeted dynamic microbubble sonographic contrast characterization (non-cardiac); initial lesion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6697","name":"Cus elbo skt in not con/atyp","description":"Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"92970","name":"Cardioassist internal","description":"Cardioassist-method of circulatory assist; internal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"35226","name":"Repair blood vessel dir lxtr","description":"Repair blood vessel, direct; lower extremity","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":728.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69210","name":"Remove impacted ear wax uni","description":"Removal impacted cerumen requiring instrumentation, unilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5828","name":"Endo knee-shin fluid swg/sta","description":"Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1712.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.56,"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":"35189","name":"Rpr acq av fistula thrx&abd","description":"Repair, acquired or traumatic arteriovenous fistula; thorax and abdomen","date_of_service":"2026-05-10","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":"42200","name":"Reconstruct cleft palate","description":"Palatoplasty for cleft palate, soft and/or hard palate only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J0475","name":"Baclofen 10 mg injection","description":"Injection, baclofen, 10 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":180.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95180","name":"Rapid desensitization","description":"Rapid desensitization procedure, each hour (eg, insulin, penicillin, equine serum)","date_of_service":"2026-05-10","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":"E0156","name":"Walker seat attachment","description":"Seat attachment, walker","date_of_service":"2026-05-10","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":"88125","name":"Forensic cytopathology","description":"Cytopathology, forensic (eg, sperm)","date_of_service":"2026-05-10","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":"44187","name":"Lap ileo/jejuno-stomy","description":"Laparoscopy, surgical; ileostomy or jejunostomy, non-tube","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1169.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L4398","name":"Foot drop splint pre ots","description":"Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93616","name":"Esophageal recording w/pacg","description":"Esophageal recording of atrial electrogram with or without ventricular electrogram(s); with pacing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6411","name":"Non-sterile eye pad","description":"Eye pad, non-sterile, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"75957","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2389","name":"Foam caster tire","description":"Power wheelchair accessory, foam caster tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82390","name":"Assay of ceruloplasmin","description":"Ceruloplasmin","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4432","name":"Os pch urine w bar/fange/tap","description":"Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each","date_of_service":"2026-05-10","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":"84260","name":"Assay of serotonin","description":"Serotonin","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":241.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"82938","name":"Gastrin test","description":"Gastrin after secretin stimulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43340","name":"Fuse esophagus & intestine","description":"Esophagojejunostomy (without total gastrectomy); abdominal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"64613","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0784","name":"Ext amb infusn pump insulin","description":"External ambulatory infusion pump, insulin","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00846","name":"Anes iper px rad hystrectomy","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; radical hysterectomy","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3332","name":"Shoe lifts tapered to one-ha","description":"Lift, elevation, inside shoe, tapered, up to one-half inch","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"95953","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":293.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00700","name":"Anes px upr ant abd wall nos","description":"Anesthesia for procedures on upper anterior abdominal wall; not otherwise specified","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0627","name":"Seat lift mech, electric any","description":"Seat lift mechanism, electric, any type","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2334.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0445","name":"Oximeter non-invasive","description":"Oximeter device for measuring blood oxygen levels non-invasively","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":548.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26030","name":"Drainage of palm bursas","description":"Drainage of palmar bursa; multiple bursa","date_of_service":"2026-05-10","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":"65710","name":"Corneal transplant","description":"Keratoplasty (corneal transplant); anterior lamellar","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":676.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"69705","name":"Nps surg dilat eust tube uni","description":"Nasopharyngoscopy, surgical, with dilation of eustachian tube (ie, balloon dilation); unilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2476.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"20827","name":"Replantation thumb complete","description":"Replantation, thumb (includes distal tip to mp joint), complete amputation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3054.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9380","name":"Inj teclistamab cqyv 0.5 mg","description":"Injection, teclistamab-cqyv, 0.5 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":17.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3995","name":"Sock fracture or equal each","description":"Addition to upper extremity orthosis, sock, fracture or equal, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4434","name":"Ost pch urine w lock flng/ft","description":"Ostomy pouch, urinary; for use on barrier with locking flange, with faucet-type tap with valve (2 piece), each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5711","name":"Knee-shin exo mnl lock ultra","description":"Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1480.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":409.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1069.78,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":54.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00216","name":"Anes icr px vascular px","description":"Anesthesia for intracranial procedures; vascular procedures","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2322","name":"Mult mech switches","description":"Power wheelchair accessory, hand control interface, multiple mechanical switches, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2369","name":"Pwr wc drivewheel gear repl","description":"Power wheelchair component, drive wheel gear box, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":946.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"57291","name":"Construction of vagina","description":"Construction of artificial vagina; without graft","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1846","name":"Ko w adj flex/ext rotat mold","description":"Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"32810","name":"Close chest after drainage","description":"Closure of chest wall following open flap drainage for empyema (clagett type procedure)","date_of_service":"2026-05-10","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":"46221","name":"Ligation of hemorrhoid(s)","description":"Hemorrhoidectomy, internal, by rubber band ligation(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"57540","name":"Removal of residual cervix","description":"Excision of cervical stump, abdominal approach;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31750","name":"Tracheoplasty cervical","description":"Tracheoplasty; cervical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1440.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"A7505","name":"Hmes or trach valve housing","description":"Housing, reusable without adhesive, for use in a heat and moisture exchange system and/or with a tracheostoma valve, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"73564","name":"X-ray exam knee 4 or more","description":"Radiologic examination, knee; complete, 4 or more views","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6672","name":"Harness chest/shlder saddle","description":"Upper extremity addition, harness, chest or shoulder, saddle type","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":646.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5649","name":"Isch containmt/narrow m-l so","description":"Addition to lower extremity, ischial containment/narrow m-l socket","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8500","name":"Artificial larynx","description":"Artificial larynx, any type","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"72220","name":"X-ray exam sacrum tailbone","description":"Radiologic examination, sacrum and coccyx, minimum of 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":591.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51820","name":"Revision of urinary tract","description":"Cystourethroplasty with unilateral or bilateral ureteroneocystostomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1231.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0056","name":"Seat ht <17 or >=21 ltwt wc","description":"Seat height less than 17 or equal to or greater than 21 for a high strength, lightweight, or ultralightweight wheelchair","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2060","name":"Lorazepam injection","description":"Injection, lorazepam, 2 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33606","name":"Anastomosis/artery-aorta","description":"Anastomosis of pulmonary artery to aorta (damus-kaye-stansel procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2184.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"51840","name":"Attach bladder/urethra","description":"Anterior vesicourethropexy, or urethropexy (eg, marshall-marchetti-krantz, burch); simple","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"J0743","name":"Cilastatin sodium injection","description":"Injection, cilastatin sodium; imipenem, per 250 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":11.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":823.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"23105","name":"Arthrotomy glenohumeral jt","description":"Arthrotomy; glenohumeral joint, with synovectomy, with or without biopsy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":766.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3912","name":"Hfo flexion glove pre ots","description":"Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00872","name":"Anes lithotrp esw water bath","description":"Anesthesia for lithotripsy, extracorporeal shock wave; with water bath","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"27696","name":"Repair of ankle ligaments","description":"Repair, primary, disrupted ligament, ankle; both collateral ligaments","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":726.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2270","name":"Varus/valgus strap padded/li","description":"Addition to lower extremity, varus/valgus correction (t) strap, padded/lined or malleolus pad","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4280","name":"Brst prsths adhsv attchmnt","description":"Adhesive skin support attachment for use with external breast prosthesis, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1390","name":"Oxygen concentrator","description":"Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["MS"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0480","name":"Tlso rigid plastic custom fa","description":"Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, res","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"65435","name":"Curette/treat cornea","description":"Removal of corneal epithelium; with or without chemocauterization (abrasion, curettage)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"20500","name":"Njx sinus tract therapeutic","description":"Injection of sinus tract; therapeutic (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"50060","name":"Nl removal calculus","description":"Nephrolithotomy; removal of calculus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1241.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50700","name":"Revision of ureter","description":"Ureteroplasty, plastic operation on ureter (eg, stricture)","date_of_service":"2026-05-10","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":"77790","name":"Radiation handling","description":"Supervision, handling, loading of radiation source","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76065","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21267","name":"Revise eye sockets","description":"Orbital repositioning, periorbital osteotomies, unilateral, with bone grafts; extracranial approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1356.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0206","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":298.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2206","name":"Man wc whl lock comp repl ea","description":"Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1360.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"39531","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"91020","name":"Gastric motility studies","description":"Gastric motility (manometric) studies","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64818","name":"Sympathectomy lumbar","description":"Sympathectomy, lumbar","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":755.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3610","name":"Trans shoe caliper plate new","description":"Transfer of an orthosis from one shoe to another, caliper plate, new","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"72295","name":"X-ray of lower spine disk","description":"Discography, lumbar, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96002","name":"Dynamic surface emg","description":"Dynamic surface electromyography, during walking or other functional activities, 1-12 muscles","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3960","name":"Sewho airplan desig abdu pos","description":"Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":196.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86777","name":"Toxoplasma antibody","description":"Antibody; toxoplasma","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J0881","name":"Darbepoetin alfa, non-esrd","description":"Injection, darbepoetin alfa, 1 microgram (non-esrd use)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"61888","name":"Revise/remove neuroreceiver","description":"Revision or removal of cranial neurostimulator pulse generator or receiver","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"46040","name":"I&d ischiorct&/perirct absc","description":"Incision and drainage of ischiorectal and/or perirectal abscess (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":437.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77057","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E0978","name":"W/c acc,saf belt pelv strap","description":"Wheelchair accessory, positioning belt/safety belt/pelvic strap, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2001.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["AW"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"54440","name":"Repair of penis","description":"Plastic operation of penis for injury","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":91.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V5363","name":"Language screening","description":"Language screening","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4334","name":"Urinary cath leg strap","description":"Urinary catheter anchoring device, leg strap, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"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":"2026-05-10","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":"A6555","name":"G com stcking bk 40+ custm","description":"Gradient compression stocking, below knee, 40 mmhg or greater, custom, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":553.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":833.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"11102","name":"Tangntl bx skin single les","description":"Tangential biopsy of skin (eg, shave, scoop, saucerize, curette); single lesion","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":61.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0824","name":"Pwc gp 2 hd seat/back","description":"Power wheelchair, group 2 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1815.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43605","name":"Biopsy of stomach","description":"Biopsy of stomach, by laparotomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":839.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"50526","name":"Close nephrovisceral fistula","description":"Closure of nephrovisceral fistula (eg, renocolic), including visceral repair; thoracic approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":77.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1029.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":264.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3740","name":"Cuffs adj lock w/ active con","description":"Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":601.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"55180","name":"Revision of scrotum","description":"Scrotoplasty; complicated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":747.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":48.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J2730","name":"Pralidoxime chloride inj","description":"Injection, pralidoxime chloride, up to 1 gm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1933","name":"Afo rig ant tib tcf/= ots","description":"Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":203.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2203","name":"Lens sphcyl bifocal 4.00d/.1","description":"Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens","date_of_service":"2026-05-10","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":"31830","name":"Revise windpipe scar","description":"Revision of tracheostomy scar","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":401.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":863.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"73040","name":"Contrast x-ray of shoulder","description":"Radiologic examination, shoulder, arthrography, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":140.55,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"29804","name":"Jaw arthroscopy/surgery","description":"Arthroscopy, temporomandibular joint, surgical","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L8610","name":"Ocular implant","description":"Ocular implant","date_of_service":"2026-05-10","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":"84234","name":"Assay of progesterone","description":"Receptor assay; progesterone","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0969","name":"Wheelchair narrowing device","description":"Narrowing device, wheelchair","date_of_service":"2026-05-10","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":"28715","name":"Arthrodesis triple","description":"Arthrodesis; triple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0747","name":"Elec osteogen stim not spine","description":"Osteogenesis stimulator, electrical, non-invasive, other than spinal applications","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":81.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"L1904","name":"Afo molded ankle gauntlet","description":"Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"34530","name":"Leg vein fusion","description":"Saphenopopliteal vein anastomosis","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4612","name":"Battery cables","description":"Battery cables; replacement for patient-owned ventilator","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26320","name":"Removal of implant from hand","description":"Removal of implant from finger or hand","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"67906","name":"Repair eyelid defect","description":"Repair of blepharoptosis; superior rectus technique with fascial sling (includes obtaining fascia)","date_of_service":"2026-05-10","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":"19020","name":"Mastotomy expl drg absc dp","description":"Mastotomy with exploration or drainage of abscess, deep","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","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":"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":"2026-05-10","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":"46730","name":"Construction of absent anus","description":"Repair of high imperforate anus without fistula; perineal or sacroperineal approach","date_of_service":"2026-05-10","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":"53500","name":"Urethrlys transvag w/ scope","description":"Urethrolysis, transvaginal, secondary, open, including cystourethroscopy (eg, postsurgical obstruction, scarring)","date_of_service":"2026-05-10","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":"82963","name":"Assay of glucosidase","description":"Glucosidase, beta","date_of_service":"2026-05-10","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":"K0020","name":"Fixed adjust armrest pair","description":"Fixed, adjustable height armrest, pair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"82300","name":"Assay of cadmium","description":"Cadmium","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"43450","name":"Dilate esophagus 1/mult pass","description":"Dilation of esophagus, by unguided sound or bougie, single or multiple passes","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":95.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5858","name":"Stance phase only","description":"Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"45402","name":"Lap proctopexy w/sig resect","description":"Laparoscopy, surgical; proctopexy (for prolapse), with sigmoid resection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1673.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1400.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2060","name":"Hkafo torsion ball bearing j","description":"Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42961","name":"Control throat bleeding","description":"Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); complicated, requiring hospitalization","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"78730","name":"Urinary bladder retention","description":"Urinary bladder residual study (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1828","name":"Adjust toe extension device","description":"Dynamic adjustable toe extension only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"84143","name":"Assay of 17-hydroxypregneno","description":"17-hydroxypregnenolone","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":31.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2360","name":"22nf nonsealed leadacid","description":"Power wheelchair accessory, 22nf non-sealed lead acid battery, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"G0507","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"95867","name":"Ndl emg cranial nrv musc uni","description":"Needle electromyography; cranial nerve supplied muscle(s), unilateral","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"44204","name":"Laparo partial colectomy","description":"Laparoscopy, surgical; colectomy, partial, with anastomosis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01464","name":"Anes arthrs px ankle&/foot","description":"Anesthesia for arthroscopic procedures of ankle and/or foot","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"20973","name":"Bone/skin graft great toe","description":"Free osteocutaneous flap with microvascular anastomosis; great toe with web space","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":315.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"A4637","name":"Repl tip cane/crutch/walker","description":"Replacement, tip, cane, crutch, walker, each.","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77409","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"37251","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"L3961","name":"Sewho cap design w/o jnts cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"48547","name":"Duodenal exclusion","description":"Duodenal exclusion with gastrojejunostomy for pancreatic injury","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45541","name":"Correct rectal prolapse","description":"Proctopexy (eg, for prolapse); perineal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":762.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":41.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31717","name":"Bronchial brush biopsy","description":"Catheterization with bronchial brush biopsy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1070","name":"Wheelchair detachable foot r","description":"Fully-reclining wheelchair, detachable arms (desk or full length) swing away detachable footrest","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1377.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KF"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6391.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"64702","name":"Revise finger/toe nerve","description":"Neuroplasty; digital, 1 or both, same digit","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"29804","name":"Jaw arthroscopy/surgery","description":"Arthroscopy, temporomandibular joint, surgical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":785.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":250.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43268","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":260.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","RR",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"67040","name":"Laser treatment of retina","description":"Vitrectomy, mechanical, pars plana approach; with endolaser panretinal photocoagulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1404.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J7505","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":830.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6682","name":"Test sock elbw disart/above","description":"Upper extremity addition, test socket, elbow disarticulation or above elbow","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"00904","name":"Anes radical perineal px","description":"Anesthesia for; radical perineal procedure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50240","name":"Nephrectomy partial","description":"Nephrectomy, partial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1074.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3919","name":"Ho w/o joints cf","description":"Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0815","name":"Pwc gp 1 std seat/back","description":"Power wheelchair, group 1 standard, sling/solid seat and back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"A7524","name":"Tracheostoma stent/stud/bttn","description":"Tracheostoma stent/stud/button, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":114.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"36860","name":"External cannula declotting","description":"External cannula declotting (separate procedure); without balloon catheter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":122.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":754.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A4340","name":"Indwelling catheter special","description":"Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"76948","name":"Echo guide ova aspiration","description":"Ultrasonic guidance for aspiration of ova, imaging supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":59.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"31554","name":"Laryngoplasty laryngeal sten","description":"Laryngoplasty; for laryngeal stenosis, with graft, with indwelling stent placement, age 12 years or older","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2373.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"20972","name":"Bone/skin graft metatarsal","description":"Free osteocutaneous flap with microvascular anastomosis; metatarsal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3071.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"91020","name":"Gastric motility studies","description":"Gastric motility (manometric) studies","date_of_service":"2026-05-10","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":"L5702","name":"Replace socket hip","description":"Replacement, socket, hip disarticulation, including hip joint, molded to patient model","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"11765","name":"Wedge excision skn nail fold","description":"Wedge excision of skin of nail fold (eg, for ingrown toenail)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"99433","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":35.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75872","name":"Vein x-ray skull epidural","description":"Venography, epidural, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38724","name":"Removal of lymph nodes neck","description":"Cervical lymphadenectomy (modified radical neck dissection)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1143.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KC"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":66.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"78610","name":"Brain flow imaging only","description":"Brain imaging, vascular flow only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1836","name":"Ko rigid w/o joints pre ots","description":"Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"28200","name":"Repair of foot tendon","description":"Repair, tendon, flexor, foot; primary or secondary, without free graft, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":395.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":170.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"21450","name":"Cltx mndblr fx w/o mnpj","description":"Closed treatment of mandibular fracture; without manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J2370","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0001","name":"Standard wheelchair","description":"Standard wheelchair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0652","name":"Pneum compres w/cal pressure","description":"Pneumatic compressor, segmental home model with calibrated gradient pressure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0994","name":"Wheelchair arm rest","description":"Arm rest, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2168.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"0034A","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"29405","name":"Appl short leg cast","description":"Application of short leg cast (below knee to toes);","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5850","name":"Endo ak/hip knee extens assi","description":"Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":793.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"K0672","name":"Removable soft interface le","description":"Addition to lower extremity orthosis, removable soft interface, all components, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L6032","name":"Part handfng ultralite tcf/=","description":"Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal)","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1161","name":"Manual adult wc w tiltinspac","description":"Manual adult size wheelchair, includes tilt in space","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33919","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2843.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"78591","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"J1640","name":"Hemin, 1 mg","description":"Injection, hemin, 1 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":362.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77084","name":"Mri bone marrow blood supply","description":"Magnetic resonance (eg, proton) imaging, bone marrow blood supply","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"77075","name":"Radex osseous survey compl","description":"Radiologic examination, osseous survey; complete (axial and appendicular skeleton)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1361.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":43.28,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"38100","name":"Removal of spleen total","description":"Splenectomy; total (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":775.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00635","name":"Anes dx/ther lumbar pnxr","description":"Anesthesia for procedures in lumbar region; diagnostic or therapeutic lumbar puncture","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"V2114","name":"Spherocylinder over 12.00d","description":"Spherocylinder, single vision, sphere over plus or minus 12.00d, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86666","name":"Ehrlichia antibody","description":"Antibody; ehrlichia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"84485","name":"Assay duodenal fluid trypsin","description":"Trypsin; duodenal fluid","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"86891","name":"Autologous blood op salvage","description":"Autologous blood or component, collection processing and storage; intra- or postoperative salvage","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"25927","name":"Amputation of hand","description":"Transmetacarpal amputation;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":998.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"K0041","name":"Large size footplate each","description":"Large size footplate, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33910","name":"Remove lung artery emboli","description":"Pulmonary artery embolectomy; with cardiopulmonary bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6677","name":"Ue triple control harness","description":"Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"25500","name":"Cltx rdl shft fx w/o mnpj","description":"Closed treatment of radial shaft fracture; without manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2224","name":"Propulsion whl excl tire rep","description":"Manual wheelchair accessory, propulsion wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":285.17,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"ATP04","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"G6010","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0981","name":"Seat upholstery, replacement","description":"Wheelchair accessory, seat upholstery, replacement only, each","date_of_service":"2026-05-10","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":"59100","name":"Remove uterus lesion","description":"Hysterotomy, abdominal (eg, for hydatidiform mole, abortion)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1001.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"82960","name":"Test for g6pd enzyme","description":"Glucose-6-phosphate dehydrogenase (g6pd); screen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0098","name":"Drive belt for pwc, repl","description":"Drive belt for power wheelchair, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"G0275","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"33223","name":"Relocate pocket for defib","description":"Relocation of skin pocket for implantable defibrillator","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":509.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"64761","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":461.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4623","name":"Tracheostomy inner cannula","description":"Tracheostomy, inner cannula","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E2343","name":"W/c dpth 22-25 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7405","name":"Add ue prost s/d acrylic","description":"Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4326","name":"Male external catheter","description":"Male external catheter with integral collection chamber, any type, each","date_of_service":"2026-05-10","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":"A4328","name":"Fem urinary collect pouch","description":"Female external urinary collection device; pouch, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"G0168","name":"Wound closure by adhesive","description":"Wound closure utilizing tissue adhesive(s) only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":34.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":675.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"92571","name":"Filtered speech test","description":"Filtered speech test","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":21.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2106.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"97542","name":"Wheelchair mngment training","description":"Wheelchair management (eg, assessment, fitting, training), each 15 minutes","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"83785","name":"Assay of manganese","description":"Manganese","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"25066","name":"Biopsy forearm soft tissues","description":"Biopsy, soft tissue of forearm and/or wrist; deep (subfascial or intramuscular)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":894.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3048.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2326","name":"Breath tube kit","description":"Power wheelchair accessory, breath tube kit for sip and puff interface","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":443.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5661","name":"Multi-durometer symes","description":"Addition to lower extremity, socket insert, multi-durometer symes","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"L5680","name":"Bk thigh lacer non-molded","description":"Addition to lower extremity, below knee, thigh lacer, nonmolded","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":32.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0992","name":"Wheelchair solid seat insert","description":"Manual wheelchair accessory, solid seat insert","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0005","name":"Ultralightweight wheelchair","description":"Ultralightweight wheelchair","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"29861","name":"Hip arthro w/fb removal","description":"Arthroscopy, hip, surgical; with removal of loose body or foreign body","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":607.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21208","name":"Augmentation of facial bones","description":"Osteoplasty, facial bones; augmentation (autograft, allograft, or prosthetic implant)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":943.52,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1686","name":"Ho post-op hip abduction","description":"Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":566.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"B9002","name":"Enter nutr inf pump any type","description":"Enteral nutrition infusion pump, any type","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"33430","name":"Replacement of mitral valve","description":"Replacement, mitral valve, with cardiopulmonary bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2436.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6206","name":"Contact layer <= 16 sq in","description":"Contact layer, sterile, 16 sq. in. or less, each dressing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"V2626","name":"Reduction of eye prosthesis","description":"Reduction of ocular prosthesis","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7503","name":"Hmes filter holder or cap","description":"Filter holder or filter cap, reusable, for use in a tracheostoma heat and moisture exchange system, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"86696","name":"Herpes simplex type 2 test","description":"Antibody; herpes simplex, type 2","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":27.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":353.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"72090","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"65093","name":"Revise eye with implant","description":"Evisceration of ocular contents; with implant","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":286.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2103","name":"Non-adju cgm receiver/mon","description":"Non-adjunctive, non-implanted continuous glucose monitor or receiver","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KF"]}],"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":"2026-05-10","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":"77076","name":"Radex osseous survey infant","description":"Radiologic examination, osseous survey, infant","date_of_service":"2026-05-10","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":"E1234","name":"Fld ped wc tltnspc w/o seat","description":"Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"01464","name":"Anes arthrs px ankle&/foot","description":"Anesthesia for arthroscopic procedures of ankle and/or foot","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":720.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":515.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2388","name":"Foam drive wheel tire","description":"Power wheelchair accessory, foam drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","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":"2026-05-10","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":"86768","name":"Salmonella antibody","description":"Antibody; salmonella","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"78111","name":"Plasma volume multiple","description":"Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); multiple samplings","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"22852","name":"Remove spine fixation device","description":"Removal of posterior segmental instrumentation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":612.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33884","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":510.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5270","name":"Tilt table locking hip sing","description":"Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0955","name":"Cushioned headrest","description":"Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":214.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"54112","name":"Treat penis lesion graft","description":"Excision of penile plaque (peyronie disease); with graft greater than 5 cm in length","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1037.85,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"78226","name":"Hepatobiliary system imaging","description":"Hepatobiliary system imaging, including gallbladder when present;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.43,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":604.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0276","name":"Bed pan fracture","description":"Bed pan, fracture, metal or plastic","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","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":"70552","name":"Mri brain stem w/dye","description":"Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"73110","name":"X-ray exam of wrist","description":"Radiologic examination, wrist; complete, minimum of 3 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":381.18,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"94681","name":"O2 uptk co2 outp % o2 xtrc","description":"Oxygen uptake, expired gas analysis; including co2 output, percentage oxygen extracted","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0841","name":"Pwc gp2 std mult pow opt s/b","description":"Power wheelchair, group 2 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":70.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","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":"00902","name":"Anes anorectal px","description":"Anesthesia for; anorectal procedure","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2670","name":"Thorac cont paraspinal uprig","description":"Addition to lower extremity, thoracic control, paraspinal uprights","date_of_service":"2026-05-10","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":"37660","name":"Ligation common iliac vein","description":"Ligation of common iliac vein","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1443.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"V2430","name":"Lens variable asphericity bi","description":"Variable asphericity lens, bifocal, full field, glass or plastic, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":60.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"56620","name":"Vulvectomy simple partial","description":"Vulvectomy simple; partial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":589.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6570","name":"Scap thorac prosth tiss shap","description":"Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4618","name":"Breathing circuits","description":"Breathing circuits","date_of_service":"2026-05-10","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":"83050","name":"Hgb methemoglobin quan","description":"Hemoglobin; methemoglobin, quantitative","date_of_service":"2026-05-10","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":"68020","name":"Incise/drain eyelid lining","description":"Incision of conjunctiva, drainage of cyst","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":117.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4327","name":"Fem urinary collect dev cup","description":"Female external urinary collection device; meatal cup, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E0434","name":"Portable liquid 02","description":"Portable liquid oxygen system, rental; includes portable container, supply reservoir, humidifier, flowmeter, refill adaptor, contents gauge, cannula or mask, and tubing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"27829","name":"Treat lower leg joint","description":"Open treatment of distal tibiofibular joint (syndesmosis) disruption, includes internal fixation, when performed","date_of_service":"2026-05-10","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":"G0104","name":"Ca screen;flexi sigmoidscope","description":"Colorectal cancer screening; flexible sigmoidoscopy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":67.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":348.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":707.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2608","name":"Skin pro/pos wc cus wd>=22in","description":"Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93875","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L3060","name":"Foot arch supp longitud/meta","description":"Foot, arch support, removable, premolded, longitudinal/ metatarsal, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"K0829","name":"Pwc gp 2 xtra hd cap chair","description":"Power wheelchair, group 2 extra heavy duty, captains chair, patient weight 601 pounds or more","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3079.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8460","name":"Shrinker above knee","description":"Prosthetic shrinker, above knee, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00950","name":"Anes vag px culdoscopy","description":"Anesthesia for vaginal procedures (including biopsy of labia, vagina, cervix or endometrium); culdoscopy","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7181","name":"Electronic elbo simultaneous","description":"Electronic elbow, microprocessor simultaneous control of elbow and terminal device","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"62005","name":"Treat skull fracture","description":"Elevation of depressed skull fracture; compound or comminuted, extradural","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1323.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J3472","name":"Ovine, 1000 usp units","description":"Injection, hyaluronidase, ovine, preservative free, per 1000 usp units","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":135.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0305","name":"Rails bed side half length","description":"Bed side rails, half length","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"19295","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":129.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-10","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":"62294","name":"Injection into spinal artery","description":"Injection procedure, arterial, for occlusion of arteriovenous malformation, spinal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":825.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":13.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"86723","name":"Listeria monocytogenes","description":"Antibody; listeria monocytogenes","date_of_service":"2026-05-10","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":"43850","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1677.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71030","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31002","name":"Irrigation sphenoid sinus","description":"Lavage by cannulation; sphenoid sinus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"41806","name":"Removal foreign body jawbone","description":"Removal of embedded foreign body from dentoalveolar structures; bone","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":277.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":255.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25922","name":"Amputate hand at wrist","description":"Disarticulation through wrist; secondary closure or scar revision","date_of_service":"2026-05-10","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":"E2612","name":"Gen use back cush wdth>=22in","description":"General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0828","name":"Pwc gp 2 xtra hd seat/back","description":"Power wheelchair, group 2 extra heavy duty, sling/solid seat/back, patient weight capacity 601 pounds or more","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"73000","name":"X-ray exam of collar bone","description":"Radiologic examination; clavicle, complete","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L1910","name":"Afo sing bar clasp attach sh","description":"Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":294.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77056","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93562","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":975.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25915","name":"Amputation of forearm","description":"Krukenberg procedure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1787.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49561","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":776.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76010","name":"X-ray nose to rectum","description":"Radiologic examination from nose to rectum for foreign body, single view, child","date_of_service":"2026-05-10","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":"A4719","name":"Y set tubing","description":"Y set tubing for peritoneal dialysis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":451.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"86765","name":"Rubeola antibody","description":"Antibody; rubeola","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L6638","name":"Elec lock on manual pw elbow","description":"Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1218.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"74245","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"91052","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"E0148","name":"Heavyduty walker no wheels","description":"Walker, heavy duty, without wheels, rigid or folding, any type, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":656.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"25622","name":"Cltx carpl scphd fx w/o mnpj","description":"Closed treatment of carpal scaphoid (navicular) fracture; without manipulation","date_of_service":"2026-05-10","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":"93531","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"27120","name":"Reconstruction of hip socket","description":"Acetabuloplasty; (eg, whitman, colonna, haygroves, or cup type)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"43405","name":"Ligate/staple esophagus","description":"Ligation or stapling at gastroesophageal junction for pre-existing esophageal perforation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3916","name":"Who nontorsion jnts pre ots","description":"Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"92145","name":"Corneal hysteresis deter","description":"Corneal hysteresis determination, by air impulse stimulation, unilateral or bilateral, with interpretation and report","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2365","name":"U1 sealed leadacid battery","description":"Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":192.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"84378","name":"Sugars single quant","description":"Sugars (mono-, di-, and oligosaccharides); single quantitative, each specimen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33410","name":"Replacement aortic valve opn","description":"Replacement, aortic valve, open, with cardiopulmonary bypass; with stentless tissue valve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2213.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93527","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2937.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":47.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"27407","name":"Repair of knee ligament","description":"Repair, primary, torn ligament and/or capsule, knee; cruciate","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":927.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"77262","name":"Ther radiology tx plng intrm","description":"Therapeutic radiology treatment planning; intermediate","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":128.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":56.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":805.62,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6235","name":"Hydrocolld drg >16<=48 w/o b","description":"Hydrocolloid dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"E1805","name":"Adjust wrist ext & flex dev","description":"Dynamic adjustable wrist extension and flexion device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0158","name":"Walker leg extenders set of4","description":"Leg extensions for walker, per set of four (4)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0705","name":"Transfer device","description":"Transfer device, any type, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0951","name":"Loop heel","description":"Heel loop/holder, any type, with or without ankle strap, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":55.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"L6623","name":"Spring-ass rot wrst w/ latch","description":"Upper extremity addition, spring assisted rotational wrist unit with latch release","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2228","name":"Mwc acc, wheelchair brake","description":"Manual wheelchair accessory, wheel braking system and lock, complete, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"72292","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E1237","name":"Rgd ped wc adjstabl w/o seat","description":"Wheelchair, pediatric size, rigid, adjustable, without seating system","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":134.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2302","name":"Lens sphere trifocal 7.12-20","description":"Sphere, trifocal, plus or minus 7.12 to plus or minus 20.00, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"00126","name":"Anes px ear tympanotomy","description":"Anesthesia for procedures on external, middle, and inner ear including biopsy; tympanotomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"76005","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3350","name":"Shoe heel wedge","description":"Heel wedge","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4426","name":"Ost pch drain 2 piece system","description":"Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"82101","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"75660","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E2622","name":"Adj skin pro w/c cus wd<22in","description":"Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1032","name":"Wheelchair joystick drive","description":"Wheelchair accessory, manual swingaway, retractable or removable mounting hardware used with joystick or other drive control interface","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":51.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":191.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1221.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":119.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"G0337","name":"Hospice evaluation preelecti","description":"Hospice evaluation and counseling services, pre-election","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"31570","name":"Laryngoscope w/vc inj","description":"Laryngoscopy, direct, with injection into vocal cord(s), therapeutic;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":290.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7520","name":"Repair prosthesis per 15 min","description":"Repair prosthetic device, labor component, per 15 minutes","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75894","name":"X-rays transcath therapy","description":"Transcatheter therapy, embolization, any method, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":933.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1655","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":790.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":686.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6945","name":"Elbow disart myoelectronic c","description":"Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"83897","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"V2312","name":"Lens sphc trifo 7.25-12/2.25","description":"Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15730","name":"Mdfc flap w/prsrv vasc pedcl","description":"Midface flap (ie, zygomaticofacial flap) with preservation of vascular pedicle(s)","date_of_service":"2026-05-10","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":"V2202","name":"Lens sphere bifocal 7.12-20.","description":"Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","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":"70210","name":"X-ray exam of sinuses","description":"Radiologic examination, sinuses, paranasal, less than 3 views","date_of_service":"2026-05-10","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":"43800","name":"Pyloroplasty","description":"Pyloroplasty","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":952.15,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4426","name":"Ost pch drain 2 piece system","description":"Ostomy pouch, drainable; for use on barrier with locking flange (2 piece system), each","date_of_service":"2026-05-10","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":"77787","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":187.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"80184","name":"Assay of phenobarbital","description":"Phenobarbital","date_of_service":"2026-05-10","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":"15945","name":"Exc isch pr ulc skn flp ostc","description":"Excision, ischial pressure ulcer, with skin flap closure; with ostectomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"71010","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"E1180","name":"Wheelchair amputee w/ foot r","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable footrests","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"43264","name":"Ercp remove duct calculi","description":"Endoscopic retrograde cholangiopancreatography (ercp); with removal of calculi/debris from biliary/pancreatic duct(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":559.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2616","name":"Pos back post/lat wdth>=22in","description":"Positioning wheelchair back cushion, posterior-lateral, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":92.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33813","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"23410","name":"Repair rotator cuff acute","description":"Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; acute","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0827","name":"Pwc gp vhd cap chair","description":"Power wheelchair, group 2 very heavy duty, captains chair, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"97545","name":"Work hardening","description":"Work hardening/conditioning; initial 2 hours","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7527","name":"Trach/laryn tube plug/stop","description":"Tracheostomy/laryngectomy tube plug/stop, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"85660","name":"Rbc sickle cell test","description":"Sickling of rbc, reduction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"77055","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E0911","name":"Hd trapeze bar attach to bed","description":"Trapeze bar, heavy duty, for patient weight capacity greater than 250 pounds, attached to bed, with grab bar","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"0499T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76873","name":"Echograp trans r pros study","description":"Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":58.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"E2101","name":"Bld glucose monitor w lance","description":"Blood glucose monitor with integrated lancing/blood sample","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"26471","name":"Fusion of finger tendons","description":"Tenodesis; of proximal interphalangeal joint, each joint","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3600","name":"Trans shoe calip plate exist","description":"Transfer of an orthosis from one shoe to another, caliper plate, existing","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J0886","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"52327","name":"Cystoscopy inject material","description":"Cystourethroscopy (including ureteral catheterization); with subureteric injection of implant material","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7669","name":"Metaproterenol non-comp unit","description":"Metaproterenol sulfate, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per 10 milligrams","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7008","name":"Disposable nebulizer prefill","description":"Large volume nebulizer, disposable, prefilled, used with aerosol compressor","date_of_service":"2026-05-10","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":"J9092","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"57420","name":"Exam of vagina w/scope","description":"Colposcopy of the entire vagina, with cervix if present;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"78261","name":"Gastric mucosa imaging","description":"Gastric mucosa imaging","date_of_service":"2026-05-10","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":"53240","name":"Surgery for urethra pouch","description":"Marsupialization of urethral diverticulum, male or female","date_of_service":"2026-05-10","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":"15331","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4258","name":"Lancet device each","description":"Spring-powered device for lancet, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J9070","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":711.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52402","name":"Cysto trurl rescj ejacul dux","description":"Cystourethroscopy with transurethral resection or incision of ejaculatory ducts","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2343","name":"W/c dpth 22-25 in seat frame","description":"Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A8002","name":"Soft protect helmet custom","description":"Helmet, protective, soft, custom fabricated, includes all components and accessories","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72291","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"A7525","name":"Tracheostomy mask","description":"Tracheostomy mask, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"L8465","name":"Shrinker upper limb","description":"Prosthetic shrinker, upper limb, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0310","name":"Rails bed side full length","description":"Bed side rails, full length","date_of_service":"2026-05-10","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":"52287","name":"Cystoscopy chemodenervation","description":"Cystourethroscopy, with injection(s) for chemodenervation of the bladder","date_of_service":"2026-05-10","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":"E1195","name":"Wheelchair amputee heavy dut","description":"Heavy duty wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-05-10","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":"96402","name":"Chemo hormon antineopl sq/im","description":"Chemotherapy administration, subcutaneous or intramuscular; hormonal anti-neoplastic","date_of_service":"2026-05-10","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":"85055","name":"Reticulated platelet assay","description":"Reticulated platelet assay","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88362","name":"Nerve teasing preparations","description":"Nerve teasing preparations","date_of_service":"2026-05-10","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":"58671","name":"Laparoscopy tubal block","description":"Laparoscopy, surgical; with occlusion of oviducts by device (eg, band, clip, or falope ring)","date_of_service":"2026-05-10","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":"82975","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"45560","name":"Repair of rectocele","description":"Repair of rectocele (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":742.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4408","name":"Ext wear ost skn barr >4sqin","description":"Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":816.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1320","name":"Amitriptyline injection","description":"Injection, amitriptyline hcl, up to 20 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A7033","name":"Replacement nasal pillows","description":"Pillow for use on nasal cannula type interface, replacement only, pair","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":"11770","name":"Exc pilonidal cyst simple","description":"Excision of pilonidal cyst or sinus; simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":199.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1042.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8501","name":"Tracheostomy speaking valve","description":"Tracheostomy speaking valve","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-10","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":"61544","name":"Remove & treat brain lesion","description":"Craniotomy with elevation of bone flap; for excision or coagulation of choroid plexus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2086.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0373","name":"Nonpowered pressure mattress","description":"Nonpowered advanced pressure reducing mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"66500","name":"Incision of iris","description":"Iridotomy by stab incision (separate procedure); except transfixion","date_of_service":"2026-05-10","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":"A9552","name":"F18 fdg","description":"Fluorodeoxyglucose f-18 fdg, diagnostic, per study dose, up to 45 millicuries","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":155.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"82135","name":"Assay aminolevulinic acid","description":"Aminolevulinic acid, delta (ala)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"15852","name":"Dressing change not for burn","description":"Dressing change (for other than burns) under anesthesia (other than local)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2624","name":"Adj skin pro/pos cus<22in","description":"Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":"28436","name":"Prq skel fix talus fx w/mnpj","description":"Percutaneous skeletal fixation of talus fracture, with manipulation","date_of_service":"2026-05-10","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":"57285","name":"Repair paravag defect vag","description":"Paravaginal defect repair (including repair of cystocele, if performed); vaginal approach","date_of_service":"2026-05-10","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":"E1005","name":"Pwr seat recline pwr","description":"Wheelchair accessory, power seating system, recline only, with power shear reduction","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"75676","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":53.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82649","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"A4452","name":"Waterproof tape","description":"Tape, waterproof, per 18 square inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["AU","AV"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":579.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"95864","name":"Needle emg 4 extremities","description":"Needle electromyography; 4 extremities with or without related paraspinal areas","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7031","name":"Replacement facemask interfa","description":"Face mask interface, replacement for full face mask, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21550","name":"Biopsy of neck/chest","description":"Biopsy, soft tissue of neck or thorax","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"32505","name":"Wedge resect of lung initial","description":"Thoracotomy; with therapeutic wedge resection (eg, mass, nodule), initial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72265","name":"Myelography l-s spine","description":"Myelography, lumbosacral, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1180","name":"Wheelchair amputee w/ foot r","description":"Amputee wheelchair, detachable arms (desk or full length) swing away detachable footrests","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"78807","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":274.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15834","name":"Exc excessive skin hip","description":"Excision, excessive skin and subcutaneous tissue (includes lipectomy); hip","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":912.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6629","name":"Lamination collar w/ couplin","description":"Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E2385","name":"Tube, pneumatic caster tire","description":"Power wheelchair accessory, tube for pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1536.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00912","name":"Anes trurl px rescj bldr tum","description":"Anesthesia for transurethral procedures (including urethrocystoscopy); transurethral resection of bladder tumor(s)","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":130.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1825.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15781","name":"Dermabrasion segmental face","description":"Dermabrasion; segmental, face","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"52355","name":"Cystouretero w/excise tumor","description":"Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with resection of ureteral or renal pelvic tumor","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4625","name":"Trach care kit for new trach","description":"Tracheostomy care kit for new tracheostomy","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1067.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":871.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":500.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87275","name":"Influenza b ag if","description":"Infectious agent antigen detection by immunofluorescent technique; influenza b virus","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":12.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2630","name":"Monosuspension arm/hand supp","description":"Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1408.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5692","name":"Ak pelvic control belt light","description":"Addition to lower extremity, above knee, pelvic control belt, light","date_of_service":"2026-05-10","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":"74177","name":"Ct abd & pelvis w/contrast","description":"Computed tomography, abdomen and pelvis; with contrast material(s)","date_of_service":"2026-05-10","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":"K0037","name":"Hi mount flip-up footrest ea","description":"High mount flip-up footrest, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0941","name":"Gravity assisted traction de","description":"Gravity assisted traction device, any type","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2620","name":"Wc planar back cush wd <22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"89220","name":"Sputum specimen collection","description":"Sputum, obtaining specimen, aerosol induced technique (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"77416","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":120.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0782","name":"Non-programble infusion pump","description":"Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KF"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7700","name":"Pros soc insert gasket/seal","description":"Gasket or seal, for use with prosthetic socket insert, any type, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0985","name":"W/c seat lift mechanism","description":"Wheelchair accessory, seat lift mechanism","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"61313","name":"Crnec/crnot sttl icere","description":"Craniectomy or craniotomy for evacuation of hematoma, supratentorial; intracerebral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2133.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":207.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7026","name":"Replace chst cmprss sys hose","description":"High frequency chest wall oscillation system hose, replacement for use with patient owned equipment, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0004","name":"High strength ltwt whlchr","description":"High strength, lightweight wheelchair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"72170","name":"X-ray exam of pelvis","description":"Radiologic examination, pelvis; 1 or 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"35587","name":"Vein byp pop-tibl peroneal","description":"In-situ vein bypass; popliteal-tibial, peroneal","date_of_service":"2026-05-10","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":"27425","name":"Lat retinacular release open","description":"Lateral retinacular release, open","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":535.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"77059","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E1700","name":"Jaw motion rehab system","description":"Jaw motion rehabilitation system","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"87147","name":"Culture type immunologic","description":"Culture, typing; immunologic method, other than immunofluorescence (eg, agglutination grouping), per antiserum","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":284.87,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":588.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"96401","name":"Chemo anti-neopl sq/im","description":"Chemotherapy administration, subcutaneous or intramuscular; non-hormonal anti-neoplastic","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1827","name":"Adjust finger flexion device","description":"Dynamic adjustable finger flexion only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":238.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"G0106","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":316.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1142.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0849","name":"Cervical pneum trac equip","description":"Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible","date_of_service":"2026-05-10","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":"L8485","name":"Pros sock single ply upper l","description":"Prosthetic sock, single ply, fitting, upper limb, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.74,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0184","name":"Dry pressure mattress","description":"Dry pressure mattress","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"H0047","name":"Alcohol/drug abuse svc nos","description":"Alcohol and/or other drug abuse services, not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"K0730","name":"Ctrl dose inh drug deliv sys","description":"Controlled dose inhalation drug delivery system","date_of_service":"2026-05-10","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":"00904","name":"Anes radical perineal px","description":"Anesthesia for; radical perineal procedure","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":182.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0954","name":"Foot box, any type each foot","description":"Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64555","name":"Implant neuroelectrodes","description":"Percutaneous implantation of neurostimulator electrode array; peripheral nerve (excludes sacral nerve)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":161.81,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E2605","name":"Position wc cush wdth <22 in","description":"Positioning wheelchair seat cushion, width less than 22 inches, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4387","name":"Ost clsd pouch w att st barr","description":"Ostomy pouch, closed, with barrier attached, with built-in convexity (1 piece), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1792.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0850","name":"Pwc gp 3 hd seat/back","description":"Power wheelchair, group 3 heavy duty, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1226","name":"Manual fully reclining back","description":"Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"01202","name":"Anes arthroscopic px hip jt","description":"Anesthesia for arthroscopic procedures of hip joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"A4270","name":"Disposable endoscope sheath","description":"Disposable endoscope sheath, each","date_of_service":"2026-05-10","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":"28660","name":"Treat toe dislocation","description":"Closed treatment of interphalangeal joint dislocation; without anesthesia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":96.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0175","name":"Perphenazine 4mg oral","description":"Perphenazine, 4 mg, oral, fda approved prescription anti-emetic, for use as a complete therapeutic substitute for an iv anti-emetic at the time of chemotherapy treatment, not to exceed a 48 hour dosage regimen","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.21,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0659","name":"Seg pneum comp head neck che","description":"Segmental pneumatic appliance for use with pneumatic compressor, integrated, head, neck and chest","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51990","name":"Laparo urethral suspension","description":"Laparoscopy, surgical; urethral suspension for stress incontinence","date_of_service":"2026-05-10","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":"28290","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":508.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":172.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5500","name":"Init bk ptb plaster direct","description":"Initial, below knee ptb type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed","date_of_service":"2026-05-10","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":"95913","name":"Nrv cndj test 13/> studies","description":"Nerve conduction studies; 13 or more studies","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"31513","name":"Injection into vocal cord","description":"Laryngoscopy, indirect; with vocal cord injection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86692","name":"Hepatitis delta agent antbdy","description":"Antibody; hepatitis, delta agent","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":23.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":73.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":376.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24582","name":"Prq skel fix humrl cndylr fx","description":"Percutaneous skeletal fixation of humeral condylar fracture, medial or lateral, with manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99298","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":165.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L5160","name":"Mold socket bent knee shin s","description":"Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76519","name":"Echo exam of eye","description":"Ophthalmic biometry by ultrasound echography, a-scan; with intraocular lens power calculation","date_of_service":"2026-05-10","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":"29900","name":"Mcp joint arthroscopy dx","description":"Arthroscopy, metacarpophalangeal joint, diagnostic, includes synovial biopsy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"44392","name":"Colonoscopy & polypectomy","description":"Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps","date_of_service":"2026-05-10","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":"V2700","name":"Balance lens","description":"Balance lens, per lens","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":87.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6533","name":"Gc stocking thighlngth 18-30","description":"Gradient compression stocking, thigh length, 18-30 mmhg, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1203.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"87269","name":"Giardia ag if","description":"Infectious agent antigen detection by immunofluorescent technique; giardia","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63280","name":"Bx/exc idrl spine lesn crvl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, cervical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"Q4034","name":"Cast sup lng leg cylinder fb","description":"Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2629.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1172.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0007","name":"Extra heavy duty wheelchair","description":"Extra heavy duty wheelchair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"45020","name":"Drainage of rectal abscess","description":"Incision and drainage of deep supralevator, pelvirectal, or retrorectal abscess","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":382.63,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"83633","name":"Test urine for lactose","description":"Lactose, urine, qualitative","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":7.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4221","name":"Supp non-insulin inf cath/wk","description":"Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs  separately)","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":190.22,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2078.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5841","name":"Addition endoskletl knee-shi","description":"Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"36471","name":"Njx sclrsnt mlt incmptnt vn","description":"Injection of sclerosant; multiple incompetent veins (other than telangiectasia), same leg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5970","name":"Foot external keel sach foot","description":"All lower extremity prostheses, foot, external keel, sach foot","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"26517","name":"Fusion of knuckle joints","description":"Capsulodesis, metacarpophalangeal joint; 2 digits","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99261","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2604","name":"Skin protect wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"30124","name":"Removal of nose lesion","description":"Excision dermoid cyst, nose; simple, skin, subcutaneous","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1038.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":311.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":145.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"86870","name":"Rbc antibody identification","description":"Antibody identification, rbc antibodies, each panel for each serum technique","date_of_service":"2026-05-10","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":"K0843","name":"Pwc gp2 hd mult pow opt s/b","description":"Power wheelchair, group 2 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93602","name":"Intra-atrial recording","description":"Intra-atrial recording","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":194.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1830","name":"Ko immob canvas long pre ots","description":"Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf","date_of_service":"2026-05-10","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":"01170","name":"Anes opn px symph pub/si jt","description":"Anesthesia for open procedures involving symphysis pubis or sacroiliac joint","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0193","name":"Powered air flotation bed","description":"Powered air flotation bed (low air loss therapy)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5503","name":"Diabetic shoe w/roller/rockr","description":"For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with roller or rigid rocker bottom, per shoe","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1112.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"69950","name":"Incise inner ear nerve","description":"Vestibular nerve section, transcranial approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2088.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.27,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3620","name":"Trans shoe solid stirrup exi","description":"Transfer of an orthosis from one shoe to another, solid stirrup, existing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"93652","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0738","name":"Portable gas oxygen system","description":"Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-05-10","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":"45305","name":"Proctosigmoidoscopy w/bx","description":"Proctosigmoidoscopy, rigid; with biopsy, single or multiple","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6805","name":"Term dev modifier wrist unit","description":"Addition to terminal device, modifier wrist unit","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":791.41,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43215","name":"Esophagoscopy flex remove fb","description":"Esophagoscopy, flexible, transoral; with removal of foreign body(s)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0980","name":"Wheelchair safety vest","description":"Safety vest, wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6621","name":"Flex/ext wrist w/wo friction","description":"Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":750.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0825","name":"Pwc gp 2 hd cap chair","description":"Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"19102","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":121.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0143","name":"Walker folding wheeled w/o s","description":"Walker, folding, wheeled, adjustable or fixed height","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":445.48,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4358","name":"Urinary leg or abdomen bag","description":"Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"23540","name":"Cltx acromclav dislc wo mnpj","description":"Closed treatment of acromioclavicular dislocation; without manipulation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":221.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":957.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21750","name":"Repair of sternum separation","description":"Closure of median sternotomy separation with or without debridement (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74150","name":"Ct abdomen w/o contrast","description":"Computed tomography, abdomen; without contrast material","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"20251","name":"Biopsy vrt bdy open lmbr/crv","description":"Biopsy, vertebral body, open; lumbar or cervical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":496.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4362","name":"Solid skin barrier","description":"Skin barrier; solid, 4 x 4 or equivalent; each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2351","name":"Electronic sgd interface","description":"Power wheelchair accessory, electronic interface to operate speech generating device using power wheelchair control interface","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15341","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":33.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"51736","name":"Urine flow measurement","description":"Simple uroflowmetry (ufr) (eg, stop-watch flow rate, mechanical uroflowmeter)","date_of_service":"2026-05-10","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":"K0017","name":"Detach adjust armrest base","description":"Detachable, adjustable height armrest, base, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"L3651","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3288.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92545","name":"Oscillating tracking test","description":"Oscillating tracking test, with recording","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2205","name":"Manual wc accessory, handrim","description":"Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L0472","name":"Tlso rigid frame hyperex pre","description":"Tlso, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coro","date_of_service":"2026-05-10","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":"0003A","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"75842","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"49021","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.16,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"J0744","name":"Ciprofloxacin iv","description":"Injection, ciprofloxacin for intravenous infusion, 200 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.57,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"72126","name":"Ct neck spine w/dye","description":"Computed tomography, cervical spine; with contrast material","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":49.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2192","name":"Pelvic band & belt thigh fla","description":"Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0959","name":"Amputee adapter","description":"Manual wheelchair accessory, adapter for amputee, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"50593","name":"Perc cryo ablate renal tum","description":"Ablation, renal tumor(s), unilateral, percutaneous, cryotherapy","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":792.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":410.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":935.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"85306","name":"Clot inhibit prot s free","description":"Clotting inhibitors or anticoagulants; protein s, free","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"21040","name":"Excise mandible lesion","description":"Excision of benign tumor or cyst of mandible, by enucleation and/or curettage","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":442.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3971","name":"Sewho cap design w/jnt(s) cf","description":"Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":833.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L8624","name":"Lith ion batt cid, ear level","description":"Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":79.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0469","name":"Lung expans high oscil neb","description":"Lung expansion airway clearance, continuous high frequency oscillation, and nebulization device","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2215","name":"Pneumatic caster tire tube","description":"Manual wheelchair accessory, tube for pneumatic caster tire, any size, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"E2384","name":"Pneumatic caster tire","description":"Power wheelchair accessory, pneumatic caster tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1780.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"35721","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"67950","name":"Revision of eyelid","description":"Canthoplasty (reconstruction of canthus)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":507.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A5120","name":"Skin barrier, wipe or swab","description":"Skin barrier, wipes or swabs, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["AV"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"74410","name":"Urography nfs drip&/bolus","description":"Urography, infusion, drip technique and/or bolus technique;","date_of_service":"2026-05-10","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":"A6534","name":"Gc stocking thighlngth 30-40","description":"Gradient compression stocking, thigh length, 30-40 mmhg, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"86023","name":"Immunoglobulin assay","description":"Antibody identification; platelet associated immunoglobulin assay","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":799.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1015.09,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"91122","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"J9050","name":"Carmustine injection","description":"Injection, carmustine, 100 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":139.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2621","name":"Wc planar back cush wd>=22in","description":"Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":"26750","name":"Treat finger fracture each","description":"Closed treatment of distal phalangeal fracture, finger or thumb; without manipulation, each","date_of_service":"2026-05-10","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":"61516","name":"Crnec treph exc cyst sttl","description":"Craniectomy, trephination, bone flap craniotomy; for excision or fenestration of cyst, supratentorial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2089.91,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"E2618","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":85.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"K0047","name":"Elev legrst upr hangr rep ea","description":"Elevating legrest, upper hanger bracket, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KF"]}],"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":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2392","name":"Solid caster tire, integrate","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"A6212","name":"Foam drg <=16 sq in w/border","description":"Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"L6000","name":"Part hand thumb rem","description":"Partial hand, thumb remaining","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":674.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"41120","name":"Partial removal of tongue","description":"Glossectomy; less than one-half tongue","date_of_service":"2026-05-10","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":"86359","name":"T cells total count","description":"T cells; total count","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"33545","name":"Repair of heart damage","description":"Repair of postinfarction ventricular septal defect, with or without myocardial resection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2571.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"44187","name":"Lap ileo/jejuno-stomy","description":"Laparoscopy, surgical; ileostomy or jejunostomy, non-tube","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":885.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00537","name":"Anes cardiac ep procedures","description":"Anesthesia for cardiac electrophysiologic procedures including radiofrequency ablation","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"68505","name":"Partial removal tear gland","description":"Excision of lacrimal gland (dacryoadenectomy), except for tumor; partial","date_of_service":"2026-05-10","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":"85530","name":"Heparin-protamine tolerance","description":"Heparin-protamine tolerance test","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"43352","name":"Surgical opening esophagus","description":"Esophagostomy, fistulization of esophagus, external; cervical approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":590.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"74430","name":"Contrast x-ray bladder","description":"Cystography, minimum of 3 views, radiological supervision and interpretation","date_of_service":"2026-05-10","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":"57511","name":"Cryocautery of cervix","description":"Cautery of cervix; cryocautery, initial or repeat","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38206","name":"Harvest auto stem cells","description":"Blood-derived hematopoietic progenitor cell harvesting for transplantation, per collection; autologous","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3397.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42845","name":"Extensive surgery of throat","description":"Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; closure with other flap","date_of_service":"2026-05-10","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":"47563","name":"Laparo cholecystectomy/graph","description":"Laparoscopy, surgical; cholecystectomy with cholangiography","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":598.07,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0620","name":"Cap bld skin piercing laser","description":"Skin piercing device for collection of capillary blood, laser, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":379.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00350","name":"Anes px major vsl neck nos","description":"Anesthesia for procedures on major vessels of neck; not otherwise specified","date_of_service":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":219.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":93.04,"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":"E0187","name":"Water pressure mattress","description":"Water pressure mattress","date_of_service":"2026-05-10","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":"97113","name":"Aquatic therapy/exercises","description":"Therapeutic procedure, 1 or more areas, each 15 minutes; aquatic therapy with therapeutic exercises","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"outpatient","service_code":["11"],"billing_code_modifier":["GO"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":650.99,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V5020","name":"Conformity evaluation","description":"Conformity evaluation","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"51860","name":"Repair of bladder wound","description":"Cystorrhaphy, suture of bladder wound, injury or rupture; simple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":616.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"71046","name":"X-ray exam chest 2 views","description":"Radiologic examination, chest; 2 views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.24,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"85675","name":"Thrombin time titer","description":"Thrombin time; titer","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"97150","name":"Group therapeutic procedures","description":"Therapeutic procedure(s), group (2 or more individuals)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"E2386","name":"Foam filled drive wheel tire","description":"Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1970","name":"Afo plastic molded w/ankle j","description":"Ankle foot orthosis, plastic with ankle joint, custom fabricated","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4388","name":"Drainable pch w ex wear barr","description":"Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5982","name":"Exoskeletal axial rotation u","description":"All exoskeletal lower extremity prostheses, axial rotation unit","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5973","name":"Ank-foot sys dors-plant flex","description":"Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1158.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0605","name":"Vaporizer room type","description":"Vaporizer, room type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"31825","name":"Repair of windpipe defect","description":"Surgical closure tracheostomy or fistula; with plastic repair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1365.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2623","name":"Adj skin pro wc cus wd>=22in","description":"Skin protection wheelchair seat cushion, adjustable, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3000","name":"Ft insert ucb berkeley shell","description":"Foot, insert, removable, molded to patient model, ucb type, berkeley shell, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"E0621","name":"Patient lift sling or seat","description":"Sling or seat, patient lift, canvas or nylon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6220","name":"Gauze >16 <=48 sq in w/bordr","description":"Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"61156","name":"Burr hol aspir hmtm/cst icer","description":"Burr hole(s); with aspiration of hematoma or cyst, intracerebral","date_of_service":"2026-05-10","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":"26180","name":"Removal of finger tendon","description":"Excision of tendon, finger, flexor or extensor, each tendon","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":520.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0482","name":"Cough stimulating device","description":"Cough stimulating device, alternating positive and negative airway pressure","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0052","name":"Swingaway detach ftrest repl","description":"Swingaway, detachable footrests, replacement only, each","date_of_service":"2026-05-10","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":"E2606","name":"Position wc cush wdth>=22 in","description":"Positioning wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"E0665","name":"Pneumatic appliance full arm","description":"Non-segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"A6523","name":"G com garment arm nght custm","description":"Gradient compression garment, arm, padded, for nighttime use, custom, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2201","name":"Man w/ch acc seat w>=20in<24in","description":"Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97113","name":"Aquatic therapy/exercises","description":"Therapeutic procedure, 1 or more areas, each 15 minutes; aquatic therapy with therapeutic exercises","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["GP","GO",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0072","name":"Fr cstr semi-pne tire rep ea","description":"Front caster assembly, complete, with semi-pneumatic tire, replacement only, each","date_of_service":"2026-05-10","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":"91122","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"93545","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":435.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0372","name":"Powered air mattress overlay","description":"Powered air overlay for mattress, standard mattress length and width","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":224.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76800","name":"Us exam spinal canal","description":"Ultrasound, spinal canal and contents","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":68.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU","","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"G0417","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3765","name":"Ewhfo rigid w/o jnts cf","description":"Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":80.72,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":239.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"93451","name":"Right heart cath","description":"Right heart catheterization including measurement(s) of oxygen saturation and cardiac output, when performed","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5585","name":"Prep ak ischial open end","description":"Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2381","name":"Pneum drive wheel tire","description":"Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1850.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"86361","name":"T cell absolute count","description":"T cells; absolute cd4 count","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"63700","name":"Repair of spinal herniation","description":"Repair of meningocele; less than 5 cm diameter","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1388.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0111","name":"Crutch forearm each","description":"Crutch forearm, includes crutches of various materials, adjustable or fixed, each, with tip and handgrips","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0470","name":"Rad w/o backup non-inv intfc","description":"Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"59620","name":"Attempted vbac delivery only","description":"Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery;","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":849.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2214","name":"Pneumatic caster tire each","description":"Manual wheelchair accessory, pneumatic caster tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L2035","name":"Kafo plastic pediatric size","description":"Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"43502","name":"Surgical repair of stomach","description":"Gastrotomy; with suture repair of pre-existing esophagogastric laceration (eg, mallory-weiss)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":110.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":107.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0046","name":"Elev lgrst lwr exten repl ea","description":"Elevating legrest, lower extension tube, replacement only, each","date_of_service":"2026-05-10","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":"E0967","name":"Man wc rim/projection rep ea","description":"Manual wheelchair accessory, hand rim with projections, any type, replacement only, each","date_of_service":"2026-05-10","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":"E0574","name":"Ultrasonic generator w svneb","description":"Ultrasonic/electronic aerosol generator with small volume nebulizer","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0105","name":"Iv hanger","description":"Iv hanger, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0988","name":"Lever-activated wheel drive","description":"Manual wheelchair accessory, lever-activated, wheel drive, pair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-10","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":"86812","name":"Hla typing a b or c","description":"Hla typing; a, b, or c (eg, a10, b7, b27), single antigen","date_of_service":"2026-05-10","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":"CPT","billing_code_type_version":"2026","billing_code":"92511","name":"Nasopharyngoscopy","description":"Nasopharyngoscopy with endoscope (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":22.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2395","name":"Caster wheel excludes tire","description":"Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"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":"2026-05-10","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":"L5716","name":"Knee-shin exo mech stance ph","description":"Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"64831","name":"Repair of digit nerve","description":"Suture of digital nerve, hand or foot; 1 nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":575.35,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1681.7,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6810","name":"Term dev precision pinch dev","description":"Addition to terminal device, precision pinch device","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0971","name":"Wheelchair anti-tipping devi","description":"Manual wheelchair accessory, anti-tipping device, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A6204","name":"Composite drsg >16<=48 sq in","description":"Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing","date_of_service":"2026-05-10","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":"E1170","name":"Whlchr ampu fxd arm leg rest","description":"Amputee wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"19304","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":783.3,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"75560","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"L3340","name":"Shoe wedge sach","description":"Heel wedge, sach","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":"38232","name":"Bone marrow harvest autolog","description":"Bone marrow harvesting for transplantation; autologous","date_of_service":"2026-05-10","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":"49321","name":"Laparoscopy biopsy","description":"Laparoscopy, surgical; with biopsy (single or multiple)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8044","name":"Hemi-facial prosthesis","description":"Hemi-facial prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":685.31,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A7045","name":"Repl exhalation port for pap","description":"Exhalation port with or without swivel used with accessories for positive airway devices, replacement only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2508","name":"Sgd spelling phys contact","description":"Speech generating device, synthesized speech, requiring message formulation by spelling and access by physical contact with the device","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"54000","name":"Slitting of prepuce","description":"Slitting of prepuce, dorsal or lateral (separate procedure); newborn","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3674","name":"So airplane w/wo joint cf","description":"Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":"33822","name":"Repair pda div<18 years","description":"Repair of patent ductus arteriosus; by division, younger than 18 years","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1826","name":"Adjust finger extension dev","description":"Dynamic adjustable finger extension only device, includes soft interface material","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J9175","name":"Elliotts b solution per ml","description":"Injection, elliotts b solution, 1 ml","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93886","name":"Intracranial complete study","description":"Transcranial doppler study of the intracranial arteries; complete study","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L4040","name":"Replace molded thigh lacer","description":"Replace molded thigh lacer, for custom fabricated orthosis only","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":18.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","26","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"68200","name":"Treat eyelid by injection","description":"Subconjunctival injection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"21110","name":"Interdental fixation","description":"Application of interdental fixation device for conditions other than fracture or dislocation, includes removal","date_of_service":"2026-05-10","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":"ATP22","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":16.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"54220","name":"Irrg crpra cavrnosa priapism","description":"Irrigation of corpora cavernosa for priapism","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"L8695","name":"External recharg sys extern","description":"External recharging system for battery (external) for use with implantable neurostimulator, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"58558","name":"Hysteroscopy biopsy","description":"Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without d & c","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":333.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"90621","name":"Menb-fhbp vacc 2/3 dose im","description":"Meningococcal recombinant lipoprotein vaccine, serogroup b (menb-fhbp), 2 or 3 dose schedule, for intramuscular use","date_of_service":"2026-05-10","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":257.39,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5704","name":"Custom shape cover bk","description":"Custom shaped protective cover, below knee","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":158.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A6502","name":"Compres burngarment chinstrp","description":"Compression burn garment, chin strap, custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2120.93,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27097","name":"Revision of hip tendon","description":"Release or recession, hamstring, proximal","date_of_service":"2026-05-10","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":"84311","name":"Spectrophotometry","description":"Spectrophotometry, analyte not elsewhere specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"28232","name":"Incision of toe tendon","description":"Tenotomy, open, tendon flexor; toe, single tendon (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":325.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["GN",""]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"63283","name":"Bx/exc idrl spine lesn scrl","description":"Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, sacral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2126.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82977","name":"Assay of ggt","description":"Glutamyltransferase, gamma (ggt)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":10.06,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"40654","name":"Rpr lip fth>1half ver ht/cpx","description":"Repair lip, full thickness; over one-half vertical height, or complex","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":449.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"54100","name":"Biopsy of penis","description":"Biopsy of penis; (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":109.14,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3137.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"69805","name":"Explore inner ear","description":"Endolymphatic sac operation; without shunt","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0608","name":"Repl garment for aed","description":"Replacement garment for use with automated external defibrillator, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"98960","name":"Edu&trn pt self-mgmt nqhp 1","description":"Education and training for patient self-management by a nonphysician qualified health care professional using a standardized curriculum, face-to-face with the patient (could include caregiver/family) each 30 minutes; individual patient","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"50370","name":"Rmvl transplanted rnl algrft","description":"Removal of transplanted renal allograft","date_of_service":"2026-05-10","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":"A6601","name":"G com bandge hgh dn foam pad","description":"Gradient compression bandaging supply, high density foam pad, any size or shape, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"64646","name":"Chemodenerv trunk musc 1-5","description":"Chemodenervation of trunk muscle(s); 1-5 muscle(s)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"15750","name":"Neurovascular pedicle flap","description":"Flap; neurovascular pedicle","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1014","name":"Reclining back add ped w/c","description":"Reclining back, addition to pediatric size wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"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":"2026-05-10","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":"92614","name":"Laryngoscopic sensory vid","description":"Flexible endoscopic evaluation, laryngeal sensory testing by cine or video recording;","date_of_service":"2026-05-10","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":"76941","name":"Echo guide for transfusion","description":"Ultrasonic guidance for intrauterine fetal transfusion or cordocentesis, imaging supervision and interpretation","date_of_service":"2026-05-10","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":"E0140","name":"Walker w trunk support","description":"Walker, with trunk support, adjustable or fixed height, any type","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"24356","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":644.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2613","name":"Position back cush wd <22in","description":"Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5270","name":"Tilt table locking hip sing","description":"Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7404","name":"Add ue prost a/e acrylic","description":"Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2202","name":"Seat width 24-27 in","description":"Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1258.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L6883","name":"Replc sockt below e/w disa","description":"Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":136.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":"00750","name":"Anes hrna rpr upr abd nos","description":"Anesthesia for hernia repairs in upper abdomen; not otherwise specified","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":113.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32000","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":90.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"21088","name":"Impres&prep facial prosth","description":"Impression and custom preparation; facial prosthesis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0968","name":"Wheelchair commode seat","description":"Commode seat, wheelchair","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1224","name":"Wheelchair spec size w/ leg","description":"Wheelchair with detachable arms, elevating legrests","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"63610","name":"Stimulation of spinal cord","description":"Stereotactic stimulation of spinal cord, percutaneous, separate procedure not followed by other surgery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":516.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L3001","name":"Foot insert remov molded spe","description":"Foot, insert, removable, molded to patient model, spenco, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":64.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52250","name":"Cystoscopy and radiotracer","description":"Cystourethroscopy with insertion of radioactive substance, with or without biopsy or fulguration","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"82654","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70250","name":"X-ray exam of skull","description":"Radiologic examination, skull; less than 4 views","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L3265","name":"Plastazote sandal each","description":"Plastazote sandal, each","date_of_service":"2026-05-10","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":"50065","name":"Nl sec surg operj calculus","description":"Nephrolithotomy; secondary surgical operation for calculus","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2382","name":"Tube, pneum wheel drive tire","description":"Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":8.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["UE","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":359.69,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"30020","name":"Drainage of nose lesion","description":"Drainage abscess or hematoma, nasal septum","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":174.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"33500","name":"Repair heart vessel fistula","description":"Repair of coronary arteriovenous or arteriocardiac chamber fistula; with cardiopulmonary bypass","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1822.19,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0679","name":"Non pneum seq comp half leg","description":"Non-pneumatic sequential compression garment, half leg","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"21705","name":"Revision of neck muscle/rib","description":"Division of scalenus anticus; with resection of cervical rib","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":470.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4404","name":"Ostomy ring each","description":"Ostomy ring, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"93613","name":"Intracardiac ephys 3d mapg","description":"Intracardiac electrophysiologic 3-dimensional mapping (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":748.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00851","name":"Anes iper px tubal ligation","description":"Anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; tubal ligation/transection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"95816","name":"Eeg awake and drowsy","description":"Electroencephalogram (eeg); including recording awake and drowsy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6380","name":"Postop dsg cast chg wrst/elb","description":"Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":88.8,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1560","name":"Gamma globulin > 10 cc inj","description":"Injection, gamma globulin, intramuscular, over 10 cc","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":100.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":948.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A4338","name":"Indwelling catheter latex","description":"Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"25491","name":"Prophylactic tx ulna","description":"Prophylactic treatment (nailing, pinning, plating or wiring) with or without methylmethacrylate; ulna","date_of_service":"2026-05-10","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":"L3580","name":"O shoe add instep velcro clo","description":"Orthopedic shoe addition, convert instep to velcro closure","date_of_service":"2026-05-10","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":"85610","name":"Prothrombin time","description":"Prothrombin time;","date_of_service":"2026-05-10","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":"A4635","name":"Underarm crutch pad","description":"Underarm pad, crutch, replacement, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"Q0480","name":"Driver pneumatic vad, rep","description":"Driver for use with pneumatic ventricular assist device, replacement only","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E2370","name":"Pwr wc dr wh motor/gear comb","description":"Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":46.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E3200","name":"Gait mod systm rhym auditory","description":"Gait modulation system, rhythmic auditory stimulation, including restricted therapy software, all components and accessories, prescription only","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2209","name":"Arm trough each","description":"Accessory, arm trough, with or without hand support, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L5678","name":"Bk joint covers pair","description":"Additions to lower extremity, below knee, joint covers, pair","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2907.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"42665","name":"Ligation of salivary duct","description":"Ligation salivary duct, intraoral","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E2212","name":"Pneumatic prop tire tube","description":"Manual wheelchair accessory, tube for pneumatic propulsion tire, any size, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"17305","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1754.32,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"38570","name":"Laparoscopy lymph node biop","description":"Laparoscopy, surgical; with retroperitoneal lymph node sampling (biopsy), single or multiple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":638.1,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":385.03,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J7340","name":"Carbidopa levodopa ent 100ml","description":"Carbidopa 5 mg/levodopa 20 mg enteral suspension, 100 ml","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.51,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":106.01,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"51570","name":"Removal of bladder","description":"Cystectomy, complete; (separate procedure)","date_of_service":"2026-05-10","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":"L3671","name":"So cap design w/o jnts cf","description":"Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":149.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3933","name":"Fo w/o joints cf","description":"Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"K0852","name":"Pwc gp 3 vhd seat/back","description":"Power wheelchair, group 3 very heavy duty, sling/solid seat/back, patient weight capacity 451 to 600 pounds","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4316","name":"Cath w/drainage 3-way","description":"Insertion tray with drainage bag with indwelling catheter, foley type, three-way, for continuous irrigation","date_of_service":"2026-05-10","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":"E0431","name":"Portable gaseous 02","description":"Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":"53420","name":"Reconstruct urethra stage 1","description":"Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; first stage","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":934.44,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"93532","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":552.97,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L1220","name":"Anterior thoracic extension","description":"Addition to tlso, (low profile), anterior thoracic extension","date_of_service":"2026-05-10","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":"A4636","name":"Handgrip for cane etc","description":"Replacement, handgrip, cane, crutch, or walker, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1574.29,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":710.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1016","name":"Shock absorber for power w/c","description":"Shock absorber for power wheelchair, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L7191","name":"Elbow child myoelectronic ct","description":"Electronic elbow, child, variety village or equal, myoelectronically controlled","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8047","name":"Nasal septal prosthesis","description":"Nasal septal prosthesis, provided by a non-physician","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":330.45,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"42950","name":"Reconstruction of throat","description":"Pharyngoplasty (plastic or reconstructive operation on pharynx)","date_of_service":"2026-05-10","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":"95957","name":"Eeg digital analysis","description":"Digital analysis of electroencephalogram (eeg) (eg, for epileptic spike analysis)","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E1029","name":"W/c vent tray fixed","description":"Wheelchair accessory, ventilator tray, fixed","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":"E0776","name":"Iv pole","description":"Iv pole","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"21325","name":"Open tx nose fx uncomplicatd","description":"Open treatment of nasal fracture; uncomplicated","date_of_service":"2026-05-10","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":"E1038","name":"Transport chair pt wt<=300lb","description":"Transport chair, adult size, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","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":"31785","name":"Remove windpipe lesion","description":"Excision of tracheal tumor or carcinoma; cervical","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1286.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"A6537","name":"Gc stocking full lngth 30-40","description":"Gradient compression stocking, full length/chap style, 30-40 mmhg, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"76529","name":"Echo exam of eye","description":"Ophthalmic ultrasonic foreign body localization","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"A4608","name":"Transtracheal oxygen cath","description":"Transtracheal oxygen catheter, each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"49550","name":"Rpr rem hernia init reduce","description":"Repair initial femoral hernia, any age; reducible","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":479.33,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"73551","name":"X-ray exam of femur 1","description":"Radiologic examination, femur; 1 view","date_of_service":"2026-05-10","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":"74329","name":"X-ray for pancreas endoscopy","description":"Endoscopic catheterization of the pancreatic ductal system, radiological supervision and interpretation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"88130","name":"Sex chromatin identification","description":"Sex chromatin identification; barr bodies","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"64911","name":"Neurorraphy w/vein autograft","description":"Nerve repair; with autogenous vein graft (includes harvest of vein graft), each nerve","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0961","name":"Wheelchair brake extension","description":"Manual wheelchair accessory, wheel lock brake extension (handle), each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"B4088","name":"Gastro/jejuno tube, low-pro","description":"Gastrostomy/jejunostomy tube, low-profile, any material, any type, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"47612","name":"Removal of gallbladder","description":"Cholecystectomy with exploration of common duct; with choledochoenterostomy","date_of_service":"2026-05-10","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":"E2362","name":"Gr24 nonsealed leadacid","description":"Power wheelchair accessory, group 24 non-sealed lead acid battery, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":40.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"96920","name":"Excimer lsr psriasis<250sqcm","description":"Excimer laser treatment for psoriasis; total area less than 250 sq cm","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61591","name":"Infratemporal approach/skull","description":"Infratemporal post-auricular approach to middle cranial fossa (internal auditory meatus, petrous apex, tentorium, cavernous sinus, parasellar area, infratemporal fossa) including mastoidectomy, resection of sigmoid sinus, with or without decompression and/or mobilization of contents of auditory cana","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3538.9,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":65.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0215","name":"Electric heat pad moist","description":"Electric heat pad, moist","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":576.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"00630","name":"Anes px lumbar region nos","description":"Anesthesia for procedures in lumbar region; not otherwise specified","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"52276","name":"Cystoscopy and treatment","description":"Cystourethroscopy with direct vision internal urethrotomy","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":309.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0973","name":"W/ch access det adj armrest","description":"Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each","date_of_service":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L1000","name":"Ctlso milwauke initial model","description":"Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model","date_of_service":"2026-05-10","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":"74241","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"15944","name":"Exc isch pr ulc skn flp clsr","description":"Excision, ischial pressure ulcer, with skin flap closure;","date_of_service":"2026-05-10","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":"44205","name":"Lap colectomy part w/ileum","description":"Laparoscopy, surgical; colectomy, partial, with removal of terminal ileum with ileocolostomy","date_of_service":"2026-05-10","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":"L4030","name":"Replace socket brim cust fit","description":"Replace quadrilateral socket brim, custom fitted","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E0189","name":"Lambswool sheepskin pad","description":"Lambswool sheepskin pad, any size","date_of_service":"2026-05-10","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":"35548","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1516.13,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":108.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"J1480","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":30.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":154.04,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51900","name":"Repair bladder/vagina lesion","description":"Closure of vesicovaginal fistula, abdominal approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":892.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":209.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1407.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"95867","name":"Ndl emg cranial nrv musc uni","description":"Needle electromyography; cranial nerve supplied muscle(s), unilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"K0018","name":"Detach adjust armrst upper","description":"Detachable, adjustable height armrest, upper portion, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":3086.56,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"83037","name":"Hb glycosylated a1c home dev","description":"Hemoglobin; glycosylated (a1c) by device cleared by fda for home use","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0668","name":"Seg pneumatic appl full arm","description":"Segmental pneumatic appliance for use with pneumatic compressor, full arm","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"00172","name":"Anes ntroral px rpr clft pal","description":"Anesthesia for intraoral procedures, including biopsy; repair of cleft palate","date_of_service":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"E1150","name":"Wheelchair standard w/ leg r","description":"Wheelchair, detachable arms, desk or full length swing away detachable elevating legrests","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"L5614","name":"4-bar link above knee w/swng","description":"Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"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":"2026-05-10","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":"44146","name":"Partial removal of colon","description":"Colectomy, partial; with coloproctostomy (low pelvic anastomosis), with colostomy","date_of_service":"2026-05-10","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":"74021","name":"Radex abdomen 3+ views","description":"Radiologic examination, abdomen; 3 or more views","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"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":"2026-05-10","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":"61550","name":"Release of skull seams","description":"Craniectomy for craniosynostosis; single cranial suture","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"26185","name":"Remove finger bone","description":"Sesamoidectomy, thumb or finger (separate procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":553.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"97039","name":"Unlisted modality","description":"Unlisted modality (specify type and time if constant attendance)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"85049","name":"Automated platelet count","description":"Blood count; platelet, automated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":6.25,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"V2105","name":"Spherocylinder 4.00d/4.25-6d","description":"Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"01210","name":"Anes open px hip joint nos","description":"Anesthesia for open procedures involving hip joint; not otherwise specified","date_of_service":"2026-05-10","locality":"1320201","zip":"10001","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":159.67,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[4]}]},{"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":101.94,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"69440","name":"Exploration of middle ear","description":"Middle ear exploration through postauricular or ear canal incision","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":765.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":4.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"00864","name":"Anes xtrprt lwr abd tot cstc","description":"Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; total cystectomy","date_of_service":"2026-05-10","locality":"1329204","zip":"11004","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":204.12,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[3]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"33010","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":89.65,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2628","name":"Mobile arm supports reclinin","description":"Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"61537","name":"Removal of brain tissue","description":"Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, without electrocorticography during surgery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2166.49,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"27418","name":"Repair degenerated kneecap","description":"Anterior tibial tubercleplasty (eg, maquet type procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"38101","name":"Removal of spleen partial","description":"Splenectomy; partial (separate procedure)","date_of_service":"2026-05-10","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":"38570","name":"Laparoscopy lymph node biop","description":"Laparoscopy, surgical; with retroperitoneal lymph node sampling (biopsy), single or multiple","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":328.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"Q0179","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":28.66,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"E0732","name":"Ces system","description":"Cranial electrotherapy stimulation (ces) system, any type","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":"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":"2026-05-10","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":"A4259","name":"Lancets per box","description":"Lancets, per box of 100","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L1831","name":"Knee orth pos locking joint","description":"Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":143.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2394","name":"Drive wheel excludes tire","description":"Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["KE","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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["GP"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":757.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":50.76,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L2136","name":"Kafo femoral fx cast rigid","description":"Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":37.71,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"43458","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320203","zip":"10512","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":152.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[2]}]},{"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE"]}],"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":"2026-05-10","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":"E2391","name":"Solid caster tire","description":"Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company 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":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":870.11,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0570","name":"Nebulizer with compression","description":"Nebulizer, with compressor","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":252.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0849","name":"Pwc gp 3 std cap chair","description":"Power wheelchair, group 3 standard, captains chair, patient weight capacity up to and including 300 pounds","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2466.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","UE","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"51555","name":"Partial removal of bladder","description":"Cystectomy, partial; complicated (eg, postradiation, previous surgery, difficult location)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1383.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1298","name":"Wheelchair spec seat depth/w","description":"Special wheelchair seat depth and/or width, by construction","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":488.53,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"3075F","name":"Syst bp ge 130 - 139mm hg","description":"Most recent systolic blood pressure 130-139 mm hg (dm) (htn, ckd, cad)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2.5,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":24.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":186.08,"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":"15793","name":"Chemical peel nonfacial drm","description":"Chemical peel, nonfacial; dermal","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"99149","name":"UNK","description":"UNK","date_of_service":"2026-05-10","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":"E2602","name":"Gen w/c cushion wdth >=22 in","description":"General use wheelchair seat cushion, width 22 inches or greater, any depth","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KE"]}],"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":"2026-05-10","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":"G0206","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"49553","name":"Rpr fem hernia init blocked","description":"Repair initial femoral hernia, any age; incarcerated or strangulated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"L8621","name":"Repl zinc air battery","description":"Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2625.83,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":69.79,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"84255","name":"Assay of selenium","description":"Selenium","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"26140","name":"Revise finger joint each","description":"Synovectomy, proximal interphalangeal joint, including extensor reconstruction, each interphalangeal joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":421.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"83525","name":"Assay of insulin","description":"Insulin; total","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":15.98,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"86310","name":"Heterophile antibody absrbj","description":"Heterophile antibodies; titers after absorption with beef cells and guinea pig kidney","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":9.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"75959","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":142.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["26","NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"31201","name":"Removal of ethmoid sinus","description":"Ethmoidectomy; intranasal, total","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":578.92,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2396","name":"Caster fork","description":"Power wheelchair accessory, caster fork, any size, replacement only, each","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1328299","zip":"12007","other_properties":[{"name":"Parent Code ","value":["SOAS"]},{"name":"ProviderCapacity","value":["PCP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":99.75,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":25.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":957.58,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E2312","name":"Mini-prop remote joystick","description":"Power wheelchair accessory, hand or chin control interface, mini-proportional remote joystick, proportional, including fixed mounting hardware","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"V2111","name":"Spherocylindr 7.25d/.25-2.25","description":"Spherocylinder, single vision, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","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":"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"K0071","name":"Fr cstr comp pne tire rep ea","description":"Front caster assembly, complete, with pneumatic tire, replacement only, each","date_of_service":"2026-05-10","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":"53210","name":"Removal of urethra","description":"Urethrectomy, total, including cystostomy; female","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":301.68,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"70487","name":"Ct maxillofacial w/dye","description":"Computed tomography, maxillofacial area; with contrast material(s)","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":["99"],"billing_code_modifier":["NU","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":374.96,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":82.0,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["CSTM-00"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6930","name":"Below elbow switch control","description":"Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"73562","name":"X-ray exam of knee 3","description":"Radiologic examination, knee; 3 views","date_of_service":"2026-05-10","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":"21261","name":"Revise eye sockets","description":"Periorbital osteotomies for orbital hypertelorism, with bone grafts; combined intra- and extracranial approach","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":2654.82,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"E2619","name":"Replace cover w/c seat cush","description":"Replacement cover for wheelchair seat cushion or back cushion, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0968","name":"Wheelchair commode seat","description":"Commode seat, wheelchair","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"E2210","name":"Wheelchair bearings","description":"Wheelchair accessory, bearings, any type, replacement only, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"L4631","name":"Afo, walk boot type, cus fab","description":"Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"31320","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"76514","name":"Echo exam of eye thickness","description":"Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":14.42,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":162.82,"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":"33241","name":"Remove pulse generator","description":"Removal of implantable defibrillator pulse generator only","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"Q4046","name":"Cast sup sht leg splnt fbrgl","description":"Cast supplies, short leg splint, adult (11 years +), fiberglass","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"76370","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":202.64,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":20.95,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6715","name":"Term device, multi art digit","description":"Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":167.05,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A6530","name":"Compression stocking bk18-30","description":"Gradient compression stocking, below knee, 18-30 mmhg, each","date_of_service":"2026-05-10","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":"15300","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":300.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","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":"L2640","name":"Pelvic control band & belt b","description":"Addition to lower extremity, pelvic control, band and belt, bilateral","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":324.88,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"K0195","name":"Elevating whlchair leg rests","description":"Elevating leg rests, pair (for use with capped rental wheelchair base)","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15261","name":"Fth/gft fr n/e/e/l each addl","description":"Full thickness graft, free, including direct closure of donor site, nose, ears, eyelids, and/or lips; each additional 20 sq cm, or part thereof (list separately in addition to code for primary procedure)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":86.47,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"15781","name":"Dermabrasion segmental face","description":"Dermabrasion; segmental, face","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":474.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":26.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0743","name":"Ext low ext nerve stimu rls","description":"External lower extremity nerve stimulator for restless legs syndrome, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["NU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"J1756","name":"Iron sucrose injection","description":"Injection, iron sucrose, 1 mg","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":0.36,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":5.6,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":131.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"82374","name":"Assay blood carbon dioxide","description":"Carbon dioxide (bicarbonate)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"58750","name":"Repair oviduct","description":"Tubotubal anastomosis","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"87164","name":"Dark field exam spec collj","description":"Dark field examination, any source (eg, penile, vaginal, oral, skin); includes specimen collection","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"85410","name":"Fibrinolytic antiplasmin","description":"Fibrinolytic factors and inhibitors; alpha-2 antiplasmin","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L2108","name":"Afo tib fx cast molded to pt","description":"Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"46940","name":"Treatment of anal fissure","description":"Curettage or cautery of anal fissure, including dilation of anal sphincter (separate procedure); initial","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":160.38,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":177.4,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":700.84,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"45340","name":"Sig w/tndsc balloon dilation","description":"Sigmoidoscopy, flexible; with transendoscopic balloon dilation","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":125.89,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":173.61,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E0550","name":"Humidif extens supple w ippb","description":"Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"78071","name":"Parathyrd planar w/wo subtrj","description":"Parathyroid planar imaging (including subtraction, when performed); with tomographic (spect)","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":386.59,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"],"billing_code_modifier":["TC"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":653.54,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":329.77,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":257.46,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":258.2,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"32482","name":"Bilobectomy","description":"Removal of lung, other than pneumonectomy; 2 lobes (bilobectomy)","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"CPT","billing_code_type_version":"2026","billing_code":"G0297","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":115.23,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93","TC"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6955","name":"Above elbow myoelectronic ct","description":"Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device","date_of_service":"2026-05-10","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":"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":"2026-05-10","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":"61516","name":"Crnec treph exc cyst sttl","description":"Craniectomy, trephination, bone flap craniotomy; for excision or fenestration of cyst, supratentorial","date_of_service":"2026-05-10","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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"HCPCS","billing_code_type_version":"2026","billing_code":"A7021","name":"Suppl and access lung expan","description":"Supplies and accessories for lung expansion airway clearance, continuous high frequency oscillation, and nebulization device (e.g., handset, nebulizer kit, biofilter)","date_of_service":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"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":"2026-05-10","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":["99"],"billing_code_modifier":["RR"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":97.37,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"E1270","name":"Wheelchair lightweight leg r","description":"Lightweight wheelchair, fixed full length arms, swing away detachable elevating legrests","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["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":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":320.86,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"K0737","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"01160","name":"Anes clsd px symph pub/si jt","description":"Anesthesia for closed procedures involving symphysis pubis or sacroiliac joint","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":116.3,"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":"73501","name":"X-ray exam hip uni 1 view","description":"Radiologic examination, hip, unilateral, with pelvis when performed; 1 view","date_of_service":"2026-05-10","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":"35637","name":"Bpg aortoiliac","description":"Bypass graft, with other than vein; aortoiliac","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company Code","value":["01","02","20","42"]},{"name":"ProductId","value":["CHPHMO","EPHMO","MEDICAIDHMO","QHPHMO","SHP"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":1467.26,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","12","21","02","65","11","24","22","10"],"billing_code_modifier":["GT","GQ","95","93"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"A4216","name":"Sterile water/saline, 10 ml","description":"Sterile water, saline and/or dextrose, diluent/flush, 10 ml","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L3040","name":"Ft arch suprt premold longit","description":"Foot, arch support, removable, premolded, longitudinal, each","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"K0038","name":"Leg strap each","description":"Leg strap, each","date_of_service":"2026-05-10","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":["99"],"billing_code_modifier":["RR","KU"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":36.08,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"Company 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":"L5974","name":"Foot single axis ankle/foot","description":"All lower extremity prostheses, foot, single axis ankle/foot","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":922.34,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":["99"],"billing_code_modifier":["UE","KU"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"92132","name":"Cptrzd oph dx img ant sgm","description":"Computerized ophthalmic diagnostic imaging (eg, optical coherence tomography [oct]), anterior segment, with interpretation and report, unilateral or bilateral","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":19.02,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["13","23","21","31","49","02","65","81","32","24","22","33"],"billing_code_modifier":["NU",""]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"CPT","billing_code_type_version":"2026","billing_code":"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":"2026-05-10","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":"0145T","name":"UNK","description":"UNK","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E1355","name":"Oxygen supplies stand/rack","description":"Stand/rack","date_of_service":"2026-05-10","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":["99"]}],"provider_references":[1]}]},{"negotiation_arrangement":"ffs","billing_code_type":"HCPCS","billing_code_type_version":"2026","billing_code":"L6582","name":"Wrist/elbow bowden cbl dir f","description":"Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"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":"E0371","name":"Nonpower mattress overlay","description":"Nonpowered advanced pressure reducing overlay for mattress, standard mattress length and width","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"94681","name":"O2 uptk co2 outp % o2 xtrc","description":"Oxygen uptake, expired gas analysis; including co2 output, percentage oxygen extracted","date_of_service":"2026-05-10","locality":"1320202","zip":"00501","other_properties":[{"name":"ProviderCapacity","value":["PCP"]},{"name":"PrimaryCarePhysicianYnFlag","value":["Y"]}],"negotiated_rates":[{"negotiated_prices":[{"negotiated_type":"negotiated","negotiated_rate":137.73,"expiration_date":"9999-12-31","billing_class":"professional","setting":"both","service_code":["99"]}],"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":"2026-05-10","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":"HCPCS","billing_code_type_version":"2026","billing_code":"A5061","name":"Pouch drainable w barrier at","description":"Ostomy pouch, drainable; with barrier attached, (1 piece), each","date_of_service":"2026-05-10","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":["99"]}],"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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":"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":"2026-05-10","locality":"1320202","zip":"00501","rural":"N","other_properties":[{"name":"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]}]}]}
